Pain Management

Use of appropriate multimodal pain management may allow patients to undergo arthroscopic rotator cuff repair without the use of opioids, according to results.

Pain management during the COVID-19 pandemic requires balancing access to care with minimizing exposure risk for front-line health care providers and vulnerable patients, according to a panel of experts who developed guidelines on best practices.

Medical cannabis is now legal in 33 states, most of which consider cancer a qualifying condition for its use in symptom palliation.

Published results showed a decrease in postoperative opioid consumption and the duration of when opioid pills are used after arthroscopic meniscectomy among patients who received preoperative opioid education.

NSAIDs provide effective symptom relief for a myriad of arthralgias and inflammatory conditions for the orthopedic patient. NSAIDs are also successfully employed as part of a perioperative multimodal pain management strategies, treatment of inflammatory processes and in joint convalescence strategies during the longer term. Overall, the frequent prescription of NSAIDs in our patient population reflects a favorable risk-benefit profile.

Recognizing a variation of practice patterns throughout its system, hospital leaders and clinicians at Brigham and Women’s Hospital created an organization-wide opioid stewardship program modeled after antibiotic stewardship programs implemented in other hospitals. Beginning in February 2016, the goal of the opioid stewardship program — called the Brigham Comprehensive Opioid Response and Education Program (B-CORE) — was to “leverage a multidisciplinary and multispecialty approach to looking at the opioid issue”, according to Scott G. Weiner, MD, MPH, director of the B-CORE Program at Brigham and Women’s Hospital.

Ultrasound-guided fascia iliaca block for hip arthroscopy is as effective at controlling postoperative pain and opioid consumption as an intra-articular injection, according to results of a published study.

At NorthShore Orthopaedic & Spine Institute, one of the cornerstones in reducing opioid prescriptions has been learning techniques that allow surgeons to not only reduce pain but speed up recovery without the use of narcotics after surgery.

In an ongoing series, Healio Orthopedics highlights new programs and approaches developed by practices to help reduce opioid use in patients. More stories from this Healio Orthopedics series can be found by clicking here.

RWJBarnabas Health in New Jersey provides full-time peer recovery specialists 24 hours a day at its hospitals as part of the health care system’s comprehensive efforts to address the opioid epidemic while improving how it approaches pain management. Through its Tackling Addiction Task Force, the system launched a multidisciplinary, multi-pronged initiative called Deliberate Reduction of Opioid Prescribing or DROP focused not only on reduction of opioid prescribing, but on enhancing how the system treats pain. This includes educating medical staff on appropriate opioid prescribing, increasing the use of evidence-based alternative practices in pain management, offering patients with substance use disorder support services and medication-assisted therapy, as needed, and building a network outside the system that creates seamless linkages to services once patients are discharged.