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02/22/2018

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Addressing the Opioid Epidemic Using Multi-Modal Pain Management Strategies

The statistics are alarming—every day an estimated 91 people die in America due to opioid overdose and an estimated 1,000 more are treated in America’s emergency rooms.

As the opioid crisis escalates and the human and societal impact mounts, hospitals and physicians alike are increasingly looking for ways to help patients manage pain throughout their hospital stay and beyond. One way to help patients recover faster with fewer side effects while reducing the use of opioids during and after surgery is by implementing Multi-Modal Pain Management (MMPM).

In a recently published MMPM OFA Anesthesiology White Paper, TeamHealth physicians Drs. Sonya Pease and David Samuels explore the benefits of MMPM programs and outline key strategies for hospitals interested in implementing these strategies.

Opioids such as morphine, oxycodone and fentanyl have long been considered the standard of care for pain management, but they come with a host of undesirable side effects such as nausea, dizziness, constipation, drowsiness and more. MMPM programs aim to provide pain relief and reduce or eliminate the use of opioids by combining two or more non-narcotic analgesic agents or other techniques. As a result, patients experience better pain control and fewer side effects.

While the benefits of using opioid alternatives after surgery are clear, there is now growing support for reducing opioid use in the operating room. New research suggests that administering opioids during surgery may actually enhance a patient’s sensitivity to pain, thereby increasing the risk of opioid dependence post-surgery. Opioid-Free Anesthesia (OFA) allows patients who have never taken narcotics to remain “opioid naïve” while reducing the need for an opioid prescription post-discharge.

Around the country TeamHealth client hospitals are seeing success with MMPM and opioid-sparing programs, including:

  • All Saints Hospital, Racine, Wisconsin: After implementing a program targeting hip fracture patients, the hospital reduced the use of pain medication by 77 percent within the first 12 hours following surgery, and post-operative pain scores fell by 51 percent within the same time-frame.
  •  Select Physicians Surgery Center, Tampa, Florida: In the outpatient setting, this facility has eliminated the use of fentanyl in more than 2,000 patients undergoing a range of procedures. Patients and surgeons have expressed satisfaction with the anesthesia protocol, and only 36 percent of patients have requested oral opioids in the post-acute care unit.

Equally important to the benefits that these programs have on clinical quality, patient safety and satisfaction is the overall impact to society by representing an important step in fighting the opioid crisis. To learn more about MMPM and OFA programs download our new MMPM OFA Anesthesiology White Paper now.