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Perioperative Pain Control in Upper Extremity Surgery: Prescribing Patterns, Recent Developments, and Opioid-Sparing Treatment Strategies

机译：上肢手术的围手术期疼痛控制：处方模式，最新进展和阿片类药物保留治疗策略

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Background: Perioperative pain management in hand and upper extremity surgery has become increasingly challenging following recent efforts to accelerate postoperative recovery, decrease length of stay, and maximize the number and complexity of surgical interventions provided in an ambulatory setting. This issue has been further complicated by the growing opioid epidemic in the United States and increasing insights into its detrimental effects on society. Practicing hand surgeons must acknowledge this ongoing public health crisis and adapt their clinical practices to minimize and optimize distribution of prescription opioids. Methods/Results: This review outlines current opioid prescribing patterns, recent developments, and treatment strategies designed to maintain effective perioperative analgesia in orthopedic upper extremity surgery while minimizing opioid delivery available for diversion, misuse, and abuse. Conclusions: The authors advise hand surgeons to utilize the strategies discussed in this review to assist in forming a unique, patient-specific postoperative analgesic regimen.
机译：背景：在最近为加快术后康复，缩短住院时间并最大程度地提高非卧床手术治疗的数量和复杂度的努力之后，手和上肢手术的围手术期疼痛管理变得越来越具有挑战性。在美国，阿片类药物的流行和对社会的有害影响的认识不断增加，使这一问题变得更加复杂。执业的手外科医师必须意识到这种持续的公共卫生危机，并调整其临床实践，以最大程度地减少和优化处方阿片类药物的分布。方法/结果：本综述概述了目前的阿片类药物处方模式，最新进展和治疗策略，旨在在骨科上肢手术中维持有效的围手术期镇痛，同时尽量减少可用于转移，滥用和滥用的阿片类药物。结论：作者建议手外科医师利用本综述中讨论的策略来协助形成独特的，针对患者的术后镇痛方案。

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