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Improving Surgical Patient Outcomes and Minimizing Risks with Opioid-Sparing Pain Control
Modules within this online curriculum aim to prepare the surgeon and surgical team in screening opioid-naïve and high-risk patients for opioid misuse; utilizing pre-, intra-, and postoperative alternatives to opioids; and practicing and implementing best discharge practices, patient education, and system quality improvements and changes.
A skills component is forthcoming and complements the seven online modules for the didactic portion. Individuals, practice groups, or hospital systems are able to obtain credentialing upon successful completion of both components in their entirety.
Course Outline
- Module 1: Introduction to the Opioid Crisis and the Surgical Team’s Role
- Module 2: An Overview of General and Local Anesthetics
- Module 3: Best Practices for Regional Anesthesia
- Module 4: Case Study - Trauma Protocols and Patient Transitions
- Module 5: Case Study - The Hernia Patient: Pre-, Intra-, and Postoperative Medications and Techniques to Minimize Opioid Use
- Module 6: Case Study - The Breast Cancer Patient: Pre-, Intra-, and Postoperative Medications and Techniques to Minimize Opioid Use
- Module 7: Transversus Abdominis Plane (TAP) Block
All modules must be completed in addition to the pre- and posttests and evaluation in order to receive CME credit.
Target Audience
This course can be taken by any member of the health care team or patient safety experts to support the didactic portion leading to the eventual credentialed training program on improving surgical patient outcomes and minimizing risks with opioid sparing pain control. Prime participants include:
- Surgeons
- Nurses
- Physician assistants
- Home care providers
- Nurse aids
- Patient safety experts
Learning Objectives
- Identify the extent and contributing factors of opioid use and misuse in the surgical patient.
- Describe post-operative prescribing practices that could decrease the risk of long-term opioid use.
- Develop solutions for the opioid crisis via patient and professional education, advocacy and policy, and clinical practice changes.
- Compare and contrast general anesthesia with local anesthetics used for regional nerve blocks.
- Demonstrate familiarity with classes of drugs and general dosing principles.
- Describe the effect the different levels of sedation have on airway, ventilation and cardiovascular status.
- Identify the patient safety measures that need to be in place for moderate sedation.
- Identify short- and long-acting local anesthetics.
- Describe factors influencing the efficacy of local anesthetics.
- Illustrate how nerve blocks can be used as part of a multimodal analgesic regimen to provide opioid-sparing or minimizing surgery.
- Review the pitfalls associated with specific nerve blocks.
- Review the components of a standardized approach to pain management for inpatients.
- Identify methods to measure patient opioid use in hernia surgery.
- Describe pharmacological, psychological, and technical interventions that can minimize opioid use following hernia repair surgery.
- Identify how to control postmastectomy postoperative pain syndrome.
- Review the science and technique associated with TAP block.
Contact
- If you have any questions about the course content, please contact surgicalpatienteducation@facs.org.
- For technical assistance, please contact learning@facs.org.
In accordance with the ACCME Accreditation Criteria, the American College of Surgeons must ensure that anyone in a position to control the content of the educational activity (planners and speakers/authors/discussants/moderators) has disclosed all financial relationships with any commercial interest (termed by the ACCME as “ineligible companies”, defined below) held in the last 24 months (see below for definitions). Please note that first authors were required to collect and submit disclosure information on behalf all other authors/contributors, if applicable.
Ineligible company
The ACCME defines an “ineligible company” as any entity producing, marketing, re-selling, or distributing health care goods or services used on or consumed by patients. Providers of clinical services directly to patients are NOT included in this definition.
Financial Relationships
Relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. ACCME considers relationships of the person involved in the CME activity to include financial relationships of a spouse or partner.
Conflict of Interest
Circumstances create a conflict of interest when an individual has an opportunity to affect CME content about products or services of an ineligible company with which he/she has a financial relationship.
The ACCME also requires that ACS manage any reported conflict and eliminate the potential for bias during the educational activity. Any conflicts noted below have been managed to our satisfaction. The disclosure information is intended to identify any commercial relationships and allow learners to form their own judgments. However, if you perceive a bias during the educational activity, please report it on the evaluation.
Faculty and Disclosures
John Daly, MD, FACS, FRCSI(Hon), FRCSG(Hon) - Nothing to disclose
Fox Chase Cancer Center, Temple Health
Philadelphia, PA
Bridget Fahy, MD, FACS - Nothing to disclose
University of New Mexico
Albuquerque, NM
Jessica Lynn Gross, MD, FACS - Nothing to disclose
Wake Forest Baptist Health
Winston-Salem, NC
Kathleen Heneghan, PhD, MSN, RN - Nothing to disclose
American College of Surgeons
Chicago, IL
Phillip Lirk, MD - Nothing to disclose
Brigham and Women’s Hospital
Boston, MA
Mark Lockett, MD, FACS - Nothing to disclose
Medical University of South Carolina
Charleston, SC
Katherine Meister, MD, FACS - Nothing to disclose
TriHealth
Cincinnati, OH
Michael Reinhorn, MD, MBA, FACS - Nothing to disclose
Boston Hernai and Pilonidal Center
Wellesley, MA
Jonah Stulberg, MD, PhD, MPH, FACS - PI, Pacira Pharmaceuticals, Inc; Speaker, Intuitive Surgical
Northwestern Memorial Hospital
Chicago, IL
Continuing Medical Education Credit Information
Accreditation
The American College of Surgeons is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA PRA Category 1 Credits™
The American College of Surgeons designates this enduring activity for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Of the AMA PRA Category 1 Credits™ listed above, a maximum of 2.75 credit meets the requirements for Self-Assessment.
Of the AMA PRA Category 1 Credits™ listed above, a maximum of 2.75 credits meets the requirements for Patient Safety.*
*The content of this activity may meet certain mandates of regulatory bodies. Please note that ACS has not and does not verify the content for such mandates with any regulatory body. Individual physicians are responsible for verifying the content satisfies such requirements.
Royal College of Physicians and Surgeons of Canada Accreditation
Through an agreement between the American College of Surgeons and the Royal College of Physicians and Surgeons of Canada, MOC Program participants may record completed self-assessment programs or simulation activities developed and accredited by the American College of Surgeons in Section 3 of the Royal College's MOC Program.
Available Credit
- 2.75 AMA PRA Category 1 Credit™
- 2.75 Certificate of Completion
- 2.75 Self Assessment Credit