We read with interest the recent editorial by Kharasch et al.1 concerning opioid management. We agree with their assessment of “opioid phobia,” and we would say “not so fast with opioid-free anesthesia.” There is no doubt that opioids are highly addictive drugs, as shown by recurring waves of opioid abuse since the nineteenth century. We appreciate that those promoting opioid-free anesthesia are well intentioned. However, neither the elimination nor the reduction of perioperative opioids have been clearly associated with decreased long-term use and abuse. As noted by Kharasch et al., the increase in prescription opioids in the attempt to address inadequate perioperative pain management was a major factor in the evolution of the opioid abuse crisis.1 Ironically, perioperative pain continues to be undertreated at this time. Despite the potential advantages of multimodal analgesia,...
Rational Perioperative Opioid Management in the Era of the Opioid Crisis: Comment
(Accepted for publication July 9, 2020. Published online first on August 4, 2020.)
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Sonia Shishido, Andrew Bowdle; Rational Perioperative Opioid Management in the Era of the Opioid Crisis: Comment. Anesthesiology 2020; 133:941–942 doi: https://doi.org/10.1097/ALN.0000000000003496
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