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Article
Title Perioperative pain management in the patient treated with opioids: Continuing Professional Development 
Author Richebe Philippe, Beaulieu Pierre  
Article Information Abstract
Publication Canadian Journal of Anesthesia  Purpose: The objective of this continuing professional development
module is to describe the perioperative anesthesia and pain
management of patients taking opioids because of chronic pain or drug
addiction. Principal findings: The number of patients under opioid
treatment is increasing. Pain management is problematic in these
patients, because regular opioid intake is associated with mechanisms of
tolerance and dependence. More recently, opioid-induced
hyperalgesia phenomena have been brought to light. As a rule, the
usual opioid dose should be administered with the appropriate
conversions, and additional requirements should be anticipated
because of the surgical procedure. Local and regional anesthesia, and
multimodal analgesia are indicated whenever possible. For the patient
addicted to heroin or other opioids, the perioperative period is not a
suitable time to initiate weaning. Conclusion: The physiological and
pharmacological changes caused by chronic opioid intake must be
understood in order to provide optimal pain management with respect to
each individual and the type of procedure


Reference BUPP10061 
Year 2009 
Logged 02/02/2010 
Volume 56 
Part 12 
Pages 969-981 
ISSN 0832-610x 
Keywords  
Comparison Drug  
Language French / English 

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