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https://hdl.handle.net/2440/95098
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Type: | Journal article |
Title: | Costs and consequences: a review of discharge opioid prescribing for ongoing management of acute pain |
Author: | Macintyre, P.E. Huxtable, C.A. Flint, S.L.P. Dobbin, M.D.H. |
Citation: | Anaesthesia and Intensive Care, 2014; 42(5):558-574 |
Publisher: | Australian Society of Anaesthetists |
Issue Date: | 2014 |
ISSN: | 0310-057X 1448-0271 |
Statement of Responsibility: | P. E. Macintyre, C. A. Huxtablet, S. L. P. Flint, M. D. H. Dobbin |
Abstract: | Over recent years there has been a growing need for patients to be sent home from hospital with prescribed opioids for ongoing management of their acute pain. Increasingly complex surgery is being performed on a day-stay or 23-hour-stay basis and inpatients after major surgery and trauma are now discharged at a much earlier stage than in the past. However, prescription of opioids to be self-administered at home is not without risk. In addition to the potential for acute adverse effects, including opioid-induced ventilatory impairment and impairment of driving skills, a review of the literature shows that opioid use continues in some patients for some years after surgery. There are also indications that over-prescription of discharge opioids occur with a significant amount not consumed, resulting in a potentially large pool of unused opioid available for later use by either the patient or others in the community. Concerns about the potential for harm arising from prescription of opioids for ongoing acute pain management after discharge are relatively recent. However, at a time when serious problems resulting from the non-medical use of opioids have reached epidemic proportions in the community, all doctors must be aware of the potential risks and be able to identify and appropriately manage patients where there might be a risk of prolonged opioid use or misuse. Anaesthetists are ideally placed to exercise stewardship over the use of opioids, so that these drugs can maintain their rightful place in the post-discharge analgesic pharmacopoeia. |
Keywords: | postoperative pain; opioids; opioid-related adverse effects; anxiety; depression; inappropriate prescribing; opioid misuse |
Rights: | Copyright of Anaesthesia & Intensive Care is the property of Australian Society of Anaesthetists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. |
DOI: | 10.1177/0310057x1404200504 |
Published version: | http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=98513182&site=ehost-live&scope=site |
Appears in Collections: | Aurora harvest 7 Medicine publications |
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