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Preoperative Chronic Pain Management: Coordination of Surgical and Anesthesiology Services in Preparation for Surgery 

Preoperative Chronic Pain Management: Coordination of Surgical and Anesthesiology Services in Preparation for Surgery
Chapter:
Preoperative Chronic Pain Management: Coordination of Surgical and Anesthesiology Services in Preparation for Surgery
Author(s):

Sherif Zaky

, Steven Rosenblatt

, and Salim Hayek

DOI:
10.1093/med/9780199349302.003.0024
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date: 19 August 2019

Abstract: This chapter describes three steps that are important in developing an efficient pain management plan for the chronic pain patient: system preparation, patient evaluation, and preoperative optimization. Education and training of healthcare providers, building an acute pain management service, and establishing metrics for outcomes are important components of system preparation. Patient evaluation includes a thorough history and physical examination, a psychological evaluation, a review of previous images, and discussion of previous and existing medications and treatment interventions. Preoperative optimization entails education, preoperative adjustment of medication, and treatment of pre-existing pain conditions. As part of a multimodal perioperative analgesia plan, premedication and the use of regional anesthesia, preferably with perineural catheters when possible, will optimize postoperative analgesia in this difficult patient population.

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