Acute Pain Management: NEW Guidelines

New guidelines for perioperative acute pain treatment in patients undergoing complex surgeries have been established by the American Society of Anesthesiologists (ASA) and 14 other societies, including American Academy of Orthopaedic Surgeons, American Academy of Otolaryngology-Head and Neck Surgery, American Association of Neurological Surgeons, American Association of Oral and Maxillofacial Surgeons, American College of Obstetricians and Gynecologists, and American College of Surgeons.

There are 7 new principles, including:

• If clinicians identify a positive screen for substance use preoperatively, a more detailed assessment tool should be utilized to risk stratify patients for additional support or referral for treatment when indicated.
• In conducting a preoperative evaluation, if a patient is identified as having chronic pain, opioid tolerance, or a substance use disorder, clinicians should coordinate with the patient's care team, including consultation with a pain medicine, behavioral health, or addiction medicine specialist.
• For patients on long-term opioid therapy preoperatively, clinicians should coordinate with the patient’s prescribing clinician and continue the baseline opioid dose in the perioperative period with supplemental analgesia as needed for postoperative acute pain.

Randall Clark, MD, FASA, is president of ASA. He commented, “Every surgical patient deserves adequate pain relief that aims to prevent opioid reliance, chronic pain and other negative outcomes, but it may be more challenging to achieve this in certain patient populations. The new principles were created to build upon an original set established last year during our first pain summit, but specifically address patients undergoing surgery with chronic pain, those taking opioids preoperatively, and those with substance use disorders. The new principles give the perioperative care team more guidance to care for these particularly complex patients.” Other societies involved: American Hospital Association, American Medical Association, American Society of Addiction Medicine, American Society of Breast Surgeons, and American Society of Plastic Surgeons.
 

Access the journal article.

Read the press release.

Other Categories:

• behavioral pain management

• chronic pain

• guidelines

• opioid therapy

• opioid use disorder (OUD)

• opioids

• pain assessment

• postsurgical pain management

• risk assessment

• risk mitigation

• substance use disorder (SUD)

• Surgery