Moderators: Michael L. Reed, DPT, OCS; Michael Y. Wang, MD, FACS
Spine surgery is one of the most common surgical procedures performed in the United States but not without significant postoperative pain. Severe or prolonged postoperative pain can delay patient recovery, impede rehabilitation, and prolong hospital length of stay. Although opioids are often used to manage postoperative pain, their use is associated with opioid related adverse events such as nausea, vomiting, constipation, itchiness, dizziness, drowsiness, ileus, and respiratory depression, which may also delay patient recovery.
Recent guidelines on the management of postoperative pain recommend using multimodal approaches to minimize the use of opioids and enhance patient recovery. Alternatives to opioids for postoperative pain include intravenous non-opioid analgesics, intravenous or oral non-steroidal anti-inflammatory drugs, intravenous or oral corticosteroids, oral adjunctive analgesics, and local infiltration with long-acting local anesthetics. This symposium will discuss the evidence supporting each of these approaches to postoperative pain, including efficacy, effectiveness, safety, and costs.
This symposium will also discuss the role of postoperative pain management in enhanced recovery after surgery (ERAS) pathways in spine surgery that aim to maximize patient recovery through patient education, fluid management, early mobilization, and medication management.
Upon completion of this session, participants should gain strategies to:
- Recognize the prevalence, severity, and consequences of postoperative pain;
- Identify risk factors and consequences of opioid related adverse events;
- Apply recommendations from the American Society of Anesthesiologists (ASA) Task Force on Acute Pain Management;
- Know the different classes of medications used in multimodal approaches to postoperative pain;
- Comprehend the impact of minimally invasive surgical (MIS) approaches on postoperative pain;
- Appreciate the role of postoperative pain management in enhanced recovery after surgery (ERAS) protocols;
- Consider the evidence supporting various approaches to manage post-operative pain with/without opioids.
Agenda
Opioid-related Adverse Events; New Narcotic Analgesic Analogues and Managing the In-hospital Overdose
Sheeraz A. Qureshi, MD, MBA
Use of Sustained Infusion/Drug Delivery (Pumps, Catheters, Patches)
Fred Geisler, MD, PhD
Anti-inflammatory Medications in the Setting of Spinal Surgery: Fusion Versus Nonfusion
Choll W. Kim, MD
The Pharmacology of Local Anesthetics and its Application to Manage Postoperative Pain, Perioperative Fluid Management
Karthik Madhavan, MD
Clinical and Pain Outcomes Measures/Monitoring in the Future
Anand Veeravagu, MD
The Role of Bracing, Therapy and Psychological Counseling in Managing Postoperative Pain
Matthew Smuck, MD
Outpatient Pain Management Following Spine Surgery
Christoph Hofstetter, MD, PhD
Building a Multidisciplinary Service for Managing Postoperative Pain
Joseph S. Cheng, MD, MS
Discussion, Questions and Answers