An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients

TY - JOUR

T1 - An international multidisciplinary consensus statement on the prevention of opioid-related harm in adult surgical patients

AU - Levy, N

AU - Quinlan, J

AU - El-Boghdadly, K

AU - Fawcett, W J

AU - Agarwal, V

AU - Bastable, R B

AU - Cox, F J

AU - de Boer, H D

AU - Dowdy, S C

AU - Hattingh, K

AU - Knaggs, R D

AU - Mariano, E R

AU - Pelosi, P

AU - Scott, M J

AU - Lobo, D N

AU - Macintyre, P E

N1 - © 2020 Association of Anaesthetists.

PY - 2020/10/7

Y1 - 2020/10/7

N2 - This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri-operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid-related harm, including persistent postoperative opioid use; opioid-induced ventilatory impairment; non-medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre-operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long-acting (modified-release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers. This consensus statement provides a framework for better prescribing practices that could help reduce the risk of postoperative opioid-related harm in adults.

AB - This international multidisciplinary consensus statement was developed to provide balanced guidance on the safe peri-operative use of opioids in adults. An international panel of healthcare professionals evaluated the literature relating to postoperative opioid-related harm, including persistent postoperative opioid use; opioid-induced ventilatory impairment; non-medical opioid use; opioid diversion and dependence; and driving under the influence of prescription opioids. Recommended strategies to reduce harm include pre-operative assessment of the risk of persistent postoperative opioid use; use of an assessment of patient function rather than unidimensional pain scores alone to guide adequacy of analgesia; avoidance of long-acting (modified-release and transdermal patches) opioid formulations and combination analgesics; limiting the number of tablets prescribed at discharge; providing deprescribing advice; avoidance of automatic prescription refills; safe disposal of unused medicines; reducing the risk of opioid diversion; and better education of healthcare professionals, patients and carers. This consensus statement provides a framework for better prescribing practices that could help reduce the risk of postoperative opioid-related harm in adults.

KW - deprescribing

KW - guidelines

KW - opioid-induced ventilatory impairment

KW - opioids

KW - peri-operative

KW - persistent postoperative opioid use

UR - http://www.scopus.com/inward/record.url?scp=85092147101&partnerID=8YFLogxK

U2 - 10.1111/anae.15262

DO - 10.1111/anae.15262

M3 - Article

C2 - 33027841

SN - 0003-2409

JO - Anaesthesia

JF - Anaesthesia

ER -