The US opioid epidemic has reached alarming levels. As many as 12.5 million Americans misuse opioids, and
more than 42,000 people died from opioid misuse in 2016, according to the Centers for Disease Control and
Prevention. Forty percent of those overdose deaths involved a prescription opioid.
2
A significant number of those addictions begin after unsuccessful pain management after surgery. Surveys
show that more than 80% of patients experience post-operative pain.
3
Three quarters report their pain as
moderate to extreme both in the immediate post-op period and after discharge.
3
Recent data demonstrate
that new persistent opioid use is one of the most common complications after elective surgery.
4
The
incidence of new persistent opioid use after major or minor surgery is thought to be around 5.9% to 6.5%.
4
In addition to opioid addiction, inadequate pain management can lead to many other negative
consequences, including increased morbidity, development of persistent postoperative pain, reduced quality
of life, delayed recovery time, and higher healthcare costs.
4,5
Improving pain management in this population
would reduce these negative ramifications.
One solution: Continuous Peripheral Nerve Blocks
Continuous peripheral nerve blocks,
or cPNB, can effectively treat acute pain
associated with a number of orthopedic
and other surgical procedures, including
thoracotomy, lower extremity joint surgery,
shoulder surgery, cesarean section,
hemorrhoid surgery, and circumcision.
9
Nerve blocks work by inhibiting pain in the
specific area that is operated on. Anesthesia
professionals place peripheral nerve blocks
using ultrasound guidance, peripheral nerve
stimulation or both. A catheter, inserted near
the nerve and connected to an ambulatory
pump, allows for continuous delivery of local
anesthetics like bupivacaine or ropivacaine. The
local anesthetic blocks the generation and the
conduction of nerve impulses, inhibiting initiation
and transmission of pain.
99% of surgical patients receive opioids and 1 in 15 of these
go on to chronic use or abuse.
6
In a study of patients receiving postsurgical opioids, the average patient
consumed 1/3 of their total prescription, leaving 4,639 leftover pills.
This creates a high potential for diversion.
7
Opioid misuse costs insurers $72.5 billion a year in healthcare costs.
8
THE OPIOID EPIDEMIC:
TIME TO IMPLEMENT ALTERNATIVE SOLUTIONS
