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  • Title: Managing surgical pain in long-term opioid patients.
    Author: Brill S.
    Journal: J Pain Palliat Care Pharmacother; 2013 Jun; 27(2):185-7. PubMed ID: 23688513.
    Abstract:
    The number of patients taking long-term opioid therapy for pain is increasing, with opioid use no longer being confined to advanced cancer patients. Challenges to peri- and postoperative pain management in chronic pain patients include complex existing drug regimens and problems arising from tolerance to opioid analgesia. Postoperatively, individualized, multimodal pain therapy involving a round-the-clock regimen of nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) inhibitors, paracetamol, and regional blocks should be used. Other considerations may include patients receiving opioids by intrathecal drug delivery systems, spinal cord stimulator (SCS), and potential substance abusers.
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