Managing postoperative pain and risk in opioid use

Opioids have long been the preferred option when prescribing analgesia for postoperative pain. However, as discussed in previous articles in this column, there is growing concern about the number of people who are prescribed opioids postoperatively and become addicted to this form of pain relief (Mendes, 2019). Therefore, there is a move to find other options in pain management and to manage the dosing of opioids, with awareness in terms of both not giving more than required and for as minimal a time as possible in the interests of the patient, while of course ensuring that the dosage is adequate to provide therapeutic benefit.

Quinlan et al (2019) from the Royal College of Physicians published a review noting that prescribed opioid misuse in North America is a public health crisis having huge social, medical and economic repercussions, with surgery as the identified driver behind persistent opioid use and misuse. They noted that the UK has also seen a surge in opioid consumption per capita, and it is now required that primary and secondary care work together to mitigate the problem of perioperative prescribed opioid misuse (Quinlan et al, 2019). Quinlan et al (2019) worked to identify the drivers behind persistent opioid misuse postoperatively and discussed the actions that can be taken by stakeholders to help prevent the UK developing its own perioperative prescribed opioid crisis.