Multimodal analgesia and opioids after hip surgery

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Edward R. Mariano, MD

This document discusses multimodal analgesia and opioids after hip surgery. It notes the opioid epidemic in the United States and examines studies on how long postoperative pain lasts after surgery. The document advocates for a personalized approach to pain medicine after surgery using multimodal analgesia to improve outcomes and reduce opioid use.

Santé & Médecine

Multimodal analgesia and
opioids after hip surgery
Edward R. Mariano, M.D., M.A.S.
Professor of Anesthesiology, Perioperative & Pain Medicine
Stanford University School of Medicine
Chief, Anesthesiology and Perioperative Care
Veterans Affairs Palo Alto Health Care System
@EMARIANOMD

@EMARIANOMD
Disclosures
 None

@EMARIANOMD
The opioid epidemic
https://www.nytimes.com/interactive/2016/01/07/us/drug-overdose-deaths-in-the-us.html?_r=0
https://www.cdc.gov/drugoverdose/epidemic/index.html

@EMARIANOMD

@EMARIANOMD

@EMARIANOMD
Brummett, et al. JAMA 2017
Klueh, et al. JGIM 2018
The role of surgery

@EMARIANOMD

@EMARIANOMD
How long does pain last?
Mariano, El-Boghdadly, Ilfeld. Anaesthesia 2020

@EMARIANOMD
Postoperative pain varies by patient
TEMPOS Group (Tighe PJ). Anesthesiology 2021

@EMARIANOMD

@EMARIANOMD
Mariano, Schatman. J Pain Res 2019

@EMARIANOMD
@DrChadB

@EMARIANOMD
Tamboli, Mariano, et al. Pain Med 2019

@EMARIANOMD

@EMARIANOMD

@EMARIANOMD
Opportunities to improve
Mariano, Walters, Kim, Kain. A&A 2015
Walters, Mariano, Clark. Pain Med 2015

@EMARIANOMD
Goal to “personalise” pain medicine

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Multimodal analgesia and opioids after hip surgery

1. Multimodal analgesia and opioids after hip surgery Edward R. Mariano, M.D., M.A.S. Professor of Anesthesiology, Perioperative & Pain Medicine Stanford University School of Medicine Chief, Anesthesiology and Perioperative Care Veterans Affairs Palo Alto Health Care System @EMARIANOMD

2. @EMARIANOMD Disclosures  None

3. @EMARIANOMD The opioid epidemic https://www.nytimes.com/interactive/2016/01/07/us/drug-overdose-deaths-in-the-us.html?_r=0 https://www.cdc.gov/drugoverdose/epidemic/index.html

6. @EMARIANOMD Brummett, et al. JAMA 2017 Klueh, et al. JGIM 2018 The role of surgery

8. @EMARIANOMD How long does pain last? Mariano, El-Boghdadly, Ilfeld. Anaesthesia 2020

9. @EMARIANOMD Postoperative pain varies by patient TEMPOS Group (Tighe PJ). Anesthesiology 2021

10. @EMARIANOMD

11. @EMARIANOMD Mariano, Schatman. J Pain Res 2019

12. @EMARIANOMD @DrChadB

13. @EMARIANOMD Tamboli, Mariano, et al. Pain Med 2019

14. @EMARIANOMD

15. @EMARIANOMD

16. @EMARIANOMD Opportunities to improve Mariano, Walters, Kim, Kain. A&A 2015 Walters, Mariano, Clark. Pain Med 2015

17. @EMARIANOMD Goal to “personalise” pain medicine