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Preoperative protocol at HSS aims to identify patients at risk for difficult pain management

Orthopedics Today reports physicians nationwide have encountered patients scheduled for orthopedic surgery who are already taking high-dose opioid pain medication. While surgeons may refer these patients to a pain management specialist, not all do, and of the patients who are referred, not all follow through with an appointment.

Orthopedics Today spoke to Seth A. Waldman, MD, director of the Pain Management Center at HSS, to discuss the perioperative program at HSS designed to identify patients at high risk for difficult pain control after surgery. This includes patients prescribed opioids above a certain dosage, on strong or long-acting opioids, with infusion pumps of opioids, with a substance abuse history or with a history of bad pain control following surgery. “The goal was to get those patients all seen by a pain management specialist beforehand so that we could speak to their provider, check their medications, know what they are on, make adjustments in medicines if possible, check toxicology screening and so on,” explained Dr. Waldman.

According to Dr. Waldman, the HSS preoperative program became more formalized around 2016 as the public became more aware of the opioid crisis. Additionally, HSS continued to adopt other protocols to reduce opioid use after surgery, starting with staff education and training. Dr. Waldman cited, “Every prescriber, every surgeon, every internist, every [physician assistant] PA, every nurse practitioner is required to take a course so that everyone has basic information with regard to the history of the opioid crisis, why opioid pain medication sometimes can cause increased pain, information about diversion, information about safe prescribing and that material became part of our enduring content.”

Read the full article at Healio.com.

Additional coverage: Beckersspine.com