TY - JOUR
T1 - Multimodal opioid sparing onco-anesthesia
T2 - A consensus practice guideline from Society of Onco-Anesthesia and Perioperative Care (SOAPC)
AU - Solanki, Sohan Lal
AU - Thota, Raghu S.
AU - Doctor, Jeson Rajan
AU - Gangakhedkar, Gauri Raman
AU - Jain, Parmanand
AU - Gottumukkala, Vijaya
AU - Garg, Rakesh
AU - Cata, Juan P.
AU - Goswami, Jyotsna
AU - Ranganath, Namrata
AU - Ramkiran, Seshadri
AU - Ghai, Babita
AU - Popat, Keyuri U.
AU - Buggy, Donal J.
AU - Pingle, Anjali A.
AU - Baxi, Vaibhavi
AU - Rayani, Basanth Kumar
AU - Thomas, Mary
AU - Bhatnagar, Sushma
AU - Divatia, Jigeeshu V.
N1 - Funding Information:
SLS and RST helped in idea, design, literature search, consensus making, manuscript writing, manuscript editing, and final approval; JRD, GRG, and VG helped in literature search, consensus making, manuscript writing and editing, and final approval; PJ helped in literature search, consensus making, manuscript editing, and final approval; RG, JPC, JG, NR, SR, and BG helped in literature search, consensus making, manuscript editing, and final approval; KUP, DJB, AAP, VB, BKR, MT, SB, and JVD helped in consensus making, manuscript editing, and final approval.
Publisher Copyright:
© 2021 Journal of Opioid Management, All Rights Reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Opioids are an indispensable part of perioperative pain management of cancer surgeries. Opioids do have some side effects and abuse potential, and some laboratory data suggest a possible association of cancer recurrence with perioperative opioid use. Opioid-free anesthesia and opioid-sparing anesthesia are emerging new concepts worldwide to safeguard patients from adverse effects of opioids and potential abuse. Opioid-free anesthesia could lead to ineffective pain management, leaving the perioperative physician with limited options, while opioid-sparing anesthesia may be a rational approach. This consensus guideline includes general considerations of the safe use of perioperative opioids along with concomitant use of central neuraxial or regional blockade and systematic nonopioid analgesics. Region-specific onco-surgeries with their specific recommendations and consensus statements for judicious use of opioids are suggested. Use of epidural analgesia or regional catheter during thoracic, abdominal, pelvic, and lower limb surgeries and use of regional nerve blocks/catheter in head neck, neuro, and upper limb onco-surgeries, wherever possible along with nonopioids analgesics, are suggested. Short-acting opioids in small aliquots may be allowed to control breakthrough pain for expedient control of pain. The purpose of this consensus practice guideline is to provide the practicing anesthesiologists with best practice evidence and consensus recommendations by the expert committee of the Society of Onco-Anesthesia and Perioperative Care for safe opioid use in onco-surgeries.
AB - Opioids are an indispensable part of perioperative pain management of cancer surgeries. Opioids do have some side effects and abuse potential, and some laboratory data suggest a possible association of cancer recurrence with perioperative opioid use. Opioid-free anesthesia and opioid-sparing anesthesia are emerging new concepts worldwide to safeguard patients from adverse effects of opioids and potential abuse. Opioid-free anesthesia could lead to ineffective pain management, leaving the perioperative physician with limited options, while opioid-sparing anesthesia may be a rational approach. This consensus guideline includes general considerations of the safe use of perioperative opioids along with concomitant use of central neuraxial or regional blockade and systematic nonopioid analgesics. Region-specific onco-surgeries with their specific recommendations and consensus statements for judicious use of opioids are suggested. Use of epidural analgesia or regional catheter during thoracic, abdominal, pelvic, and lower limb surgeries and use of regional nerve blocks/catheter in head neck, neuro, and upper limb onco-surgeries, wherever possible along with nonopioids analgesics, are suggested. Short-acting opioids in small aliquots may be allowed to control breakthrough pain for expedient control of pain. The purpose of this consensus practice guideline is to provide the practicing anesthesiologists with best practice evidence and consensus recommendations by the expert committee of the Society of Onco-Anesthesia and Perioperative Care for safe opioid use in onco-surgeries.
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U2 - 10.5055/JOM.2021.0675
DO - 10.5055/JOM.2021.0675
M3 - Review article
C2 - 34714542
AN - SCOPUS:85121405474
SN - 1551-7489
VL - 17
SP - 417
EP - 437
JO - Journal of Opioid Management
JF - Journal of Opioid Management
IS - 5
ER -