Clinical and Economic Impact of Intra- and Postoperative Use of Opioids and Analgesic Devices

Cost and Quality Implications of Opioid‐Based Postsurgical Pain Control Using Administrative Claims Data from a Large Health System: Opioid‐Related Adverse Events and Their Impact on Clinical and Economic Outcomes

“…Multivariate logistic regression was used to evaluate putative risk factors that may predispose patients to postsurgical ORADEs. Selection of factors was based on previous literature and included age, sex, race‐ethnicity, obesity (ICD‐9 diagnosis code 278.xx), degenerative joint disease (ICD‐9 diagnosis code 715.xx), opioid use before surgery, and Charlson Comorbidity Index. The Charlson Comorbidity Index was used to assess comorbidities and encompasses 19 medical conditions, each assigned a weight ranging from 1–6 .…”

“…Thus, maintenance of pain relief is a high priority in postoperative care . A mainstay of both perioperative and postoperative treatment in the United States, opioid analgesics are one of the most widely prescribed drug classes in the hospital setting . Although opioids are effective analgesics in the postsurgical setting, their effects can also be seen in other areas of the body due to activation of peripheral receptors and therefore can have unintended effects manifested as opioid‐related adverse drug events (ORADEs) such as nausea, vomiting, and allergic reactions .…”

Retrospective analysis of quality improvement when using liposome bupivacaine for postoperative pain control

“…2 – 5 The American Pain Society, in collaboration with the Pain Care Coalition, 6 has also advocated for the creation of a national pain and palliative care research and quality program that would ensure that military personnel, veterans, and Medicare beneficiaries receive appropriate pain management. 7 However, despite these efforts, there appears to have been little or no improvement in patients’ reported levels of postsurgical pain control over the past 20 years. 1 …”

Evolving Role of Local Anesthetics in Managing Postsurgical Analgesia

“…15,29,30 In the setting of postsurgical analgesia, opioids are frequently administered via patientcontrolled analgesia (PCA) devices that permit selfadministration of small opioid doses which allow patients to have some control of the prescribed analgesic regimen. 1,31 Although the use of PCA improves pain control and patient satisfaction, 32 the incidence of ADEs associated with opioid PCA appears similar to that associated with other methods of administration. 33 Moreover, the risk of errors and ADEs associated with setup, programming, and use of PCA devices was well documented.…”

“…It is estimated that 470 million surgical procedures are performed annually in the United States, and most surgical patients experience moderate-to-severe pain after surgery. 1,2 Over the past few decades, the focus has increased on improving the quality of pain management (including postsurgical pain), reflected in standards and/or guidelines established by a range of governmental and health care organizations.…”