Question

What are the potential complications of the opioid dependence client undergoing surgery?

Answer 1

Ans) The current opioid epidemic in the U.S., healthcare providers are now faced with the challenge of simultaneously optimizing postoperative pain management and limiting opioid use after surgery.

- The use of prescription opioids can have a number of side effects as well, even when taken as directed:

• Tolerance—meaning you might need to take more of a medication for the same pain relief
• Physical dependence—meaning you have symptoms of withdrawal when a medication is stopped
• Increased sensitivity to pain
• Constipation
• Nausea, vomiting, and dry mouth
• Sleepiness and dizziness
• Confusion
• Depression
• Low levels of testosterone that can result in lower sex drive, energy, and strength
• Itching and sweating

- Emerging data suggests that persistent and chronic opioid use after surgery is a rising complication amongst both opioid naive patients and those taking opioids preoperatively.

- Modifiable risk factors for chronic opioid use after surgery should be clearly delineated and targeted with novel interventions. In addition, existing interventions exhibiting opioid-sparing effects within the immediate postoperative period should be examined in randomized trials with follow-up long after hospital discharge to determine their utility in promoting definitive opioid cessation after surgery.

- Evidence-based strategies for opioid tapering are needed to complement the burgeoning guidelines and expert opinions advocating for postoperative opioid tapering to optimize patient success, prevent under-prescribing of opioids to patients, and prevent opioid misuse and diversion.