1. Educate and inform
Discuss with your patients what they should expect in terms of pain
following their procedures and your facility's pain management proto-
cols a week or two before surgery. They should know in advance, for
example, that they'll experience a spike in pain on day 2 or 3 post-op
when nerve blocks wear off. Explain the effectiveness of non-opioid
alternative therapies and how they'll play a key role in minimizing the
amount of opioids they will need to take. For example, acetamino-
phen and NSAIDs such as ibuprofen, naproxen and celecoxib are
effective adjunct therapies that limit opioid consumption.
The opioids surgeons prescribe should be for the shortest duration
possible — a 7-day supply is usually sufficient to manage pain after
most surgeries — low-dose and short-acting. Also establish a default
number of pills that are prescribed following specific procedures
(see "Standardized Scripts for Every Surgery" on page 18 for more
about recommended pill counts).
During pre-op consultations or assessments, share brochures and
other educational materials with patients about safe opioid use.
Remind them that your staff and surgeons are available at any point
before and after their procedures to answer questions they have about
your opioid-sparing protocols. Encourage patients to keep a pain
diary. Jotting down notes about how they feel can help them better
understand what treatments are working, and which aren't.
Referencing those firsthand accounts of a patient's recovery during
post-op clinic visits will help surgeons refine their pain management
regimens.
Before and after surgery, warn patients about the dangers of exces-
sive opioid use and the risks involved in combining opioids with other
substances without physician oversight. Many of the deaths character-
ized as opioid overdoses in the media are in fact the result of mixing
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