Unintentional deaths due to opioids are a major concern in the United States. This course provides expert guidance and resources to implement and evaluate an opioid-sparing program at your surgical center. Panels, video, guidelines, small group application, and algorithms will be used to teach multimodal therapy and opioid-sparing perioperative protocols. Outpatient medication prescribing and pain management patient/caregiver education—including communication, screening, optimal discharge planning, patient contracts and referrals to pain management teams—will also be discussed. Case studies will include managing opioid-naïve and opioid-tolerant patients with a focus on breast, colorectal, hernia, and trauma patients.

Opioid-Sparing Perioperative Pain Management: A Credentialed Course for the Practicing Surgeon was a Didactic Experiential Course given at Clinical Congress 2018. This course may help satisfy portions of physician state licensure and regulatory mandate certification related to pain management and/or opioid prescribing.

Course Outline

Session I: The Opioid Epidemic and Surgery: Effective Strategies to Change Trends

• ACS Initiatives and the Big Picture
  John M. Daly, MD, FACS, FRCSI(Hon), FRCSG(Hon), Philadelphia,PA
• The Veterans Affairs Quality Improvement Plan: Acute Pain Management Guide to Meet the Current Challenges
  Lisa M. Mazzia, MD, Washington, DC
• Opioid Prescribing Engagement Network (OPEN): Moving to a New Model for Pain Management
  Chad Brummett, MD, Ann Arbor, MI
• Effective Guidelines, Emergency Department, and Beyond: The Brigham Comprehensive Opioid Response and Education (B CORE) Program
  Scott Weiner, MD, MPH, Boston, MA

Session II: Multimodal Analgesics and Opioid-Sparing Guidelines: All Part of the Enhanced Recovery Plan

• The Colon and Rectal Patient: Pre-, Intra-, and Postoperative Medications and Techniques to Minimize Opioid Use
  Michael F. McGee, MD, FACS, FASCRS, Chicago, IL
• The Hernia Patient: Pre-, Intra-, and Postoperative Medications and Techniques to Minimize Opioid Use
  Michael Reinhorn, MD, FACS, Newton, MA
• The Breast Cancer Patient: Pre-, Intra-, and Postoperative Medications and Techniques to Minimize Opioid Use
  Mark A. Lockett, MD, FACS, Charleston, SC

Session III: Implementing Best Practice for Opioid-Sparing Techniques, Including Indications, Modifications, Complications, and Safety Monitoring

• Nerve Blocks: Best Practice from Assessment to Approach
  Phillip Lirk, MD, PhD, Boston, MA
• Opioid-Sparing Principles, Algorithms, and Outcomes with Considerations for the Opioid-Naïve and -Dependent Patient
  Thomas A. Aloia, MD, FACS, Houston, TX

Session IV: Outpatient Prescribing Practices and Patient Transition to Home Care Providers

• Discharge Protocols Based on Patient Analgesic Use: A Best Practice Approach to Prescribing and Managing Patient Expectations
  Michael J. Englesbe, MD, FACS, Ann Arbor, MI
• Trauma Protocols and Patient Transitions
  Jessica L. Gross, MD, FACS, Winston-Salem, NC
• The Complex Patient Discharge: Contracts, Considerations, and Referrals for the Patient with Opioid Dependency, Opioid Use Disorder, and High-Risk Comorbidities
  Timothy J. Atkinson, PharmD, BCPS, CPE, Murfreesboro, TN
• Bringing It All Together: Evaluation Model and Resources
  Kathleen Heneghan, PhD, MSN, RN, CPN, Chicago, IL