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Opioid-Free Anesthesia Is Not a Thing

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Opioid-Free Anesthesia Is Not a Thing

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By the end of this presentation, learners will be able to:
1. Discuss the current state of the opioid epidemic;
2. Review the role of opioids in anesthesia and perioperative care; and
3. Assess the value of opioid-free strategies.

By the end of this presentation, learners will be able to:
1. Discuss the current state of the opioid epidemic;
2. Review the role of opioids in anesthesia and perioperative care; and
3. Assess the value of opioid-free strategies.

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Opioid-Free Anesthesia Is Not a Thing

  1. 1. @EMARIANOMD #WAS2020 “Opioid-Free Anesthesia” Is Not a Thing Edward R. Mariano, M.D., M.A.S. Professor of Anesthesiology, Perioperative & Pain Medicine Stanford University School of Medicine Chief, Anesthesiology and Perioperative Care Veterans Affairs Palo Alto Health Care System
  2. 2. @EMARIANOMD #WAS2020 Disclosures  None
  3. 3. @EMARIANOMD #WAS2020 Overview  How did we get here?  Where is the evidence?  What should we do for our patients?
  4. 4. @EMARIANOMD #WAS2020 Overview  How did we get here?  Where is the evidence?  What should we do for our patients?
  5. 5. @EMARIANOMD #WAS2020 The Opioid Epidemic https://www.nytimes.com/interactive/2016/01/07/us/drug-overdose-deaths-in-the-us.html?_r=0 https://www.cdc.gov/drugoverdose/epidemic/index.html
  6. 6. @EMARIANOMD #WAS2020 The Opioid Epidemic https://www.nytimes.com/interactive/2016/01/07/us/drug-overdose-deaths-in-the-us.html?_r=0 https://www.cdc.gov/drugoverdose/epidemic/index.html
  7. 7. @EMARIANOMD #WAS2020 Brummett, et al. JAMA 2017 Klueh, et al. JGIM 2018
  8. 8. @EMARIANOMD #WAS2020
  9. 9. @EMARIANOMD #WAS2020 https://www.ncsl.org/research/health/prescribing-policies-states-confront-opioid-overdose-epidemic.aspx
  10. 10. @EMARIANOMD #WAS2020 Mudumbai & Mariano, et al. Pain Med 2016 The Opioid Epidemic
  11. 11. @EMARIANOMD #WAS2020 The Opioid Epidemic https://www.cdc.gov/drugoverdose/epidemic/index.html
  12. 12. @EMARIANOMD #WAS2020 The Opioid Epidemic Mudumbai & Mariano, et al. Pain Med 2016
  13. 13. @EMARIANOMD #WAS2020 Unintended Consequences
  14. 14. @EMARIANOMD #WAS2020 Overview  How did we get here?  Where is the evidence?  What should we do for our patients?
  15. 15. @EMARIANOMD #WAS2020
  16. 16. @EMARIANOMD #WAS2020
  17. 17. @EMARIANOMD #WAS2020
  18. 18. @EMARIANOMD #WAS2020 SPFA Society for Paralysis-Free Anesthesia BLOCK THE ROC LET PATIENTS MOVE FREELY DURING SURGERY ☻ 2020 Society for Paralysis-Free Anesthesia. This is totally fake.
  19. 19. @EMARIANOMD #WAS2020 Elkassabany & Mariano. Anaesthesia 2019
  20. 20. @EMARIANOMD #WAS2020 Elkassabany & Mariano. Anaesthesia 2019
  21. 21. @EMARIANOMD #WAS2020 Opioid-Free Anesthesia: PRO? Lavand’homme. EJA 2019
  22. 22. @EMARIANOMD #WAS2020 Opioid-Free Anesthesia: CON Lirk & Rathmell. EJA 2019
  23. 23. @EMARIANOMD #WAS2020 Fiore, et al. BJA 2019
  24. 24. @EMARIANOMD #WAS2020 Fiore, et al. BJA 2019
  25. 25. @EMARIANOMD #WAS2020 Kharasch, et al. Anesthesiology Feb 2020
  26. 26. @EMARIANOMD #WAS2020 Kharasch, et al. Anesthesiology Feb 2020
  27. 27. @EMARIANOMD #WAS2020 Overview  How did we get here?  Where is the evidence?  What should we do for our patients?
  28. 28. @EMARIANOMD #WAS2020 Schwenk & Mariano. KJA 2018
  29. 29. @EMARIANOMD #WAS2020 Elkassabany & Mariano. Anaesthesia 2019 Opioid- Free Potential
  30. 30. @EMARIANOMD #WAS2020 Mariano, Schatman. J Pain Res 2019
  31. 31. @EMARIANOMD #WAS2020 Think Beyond the PACU Mariano, Walters, Kim, Kain. A&A 2015 Walters, Mariano, Clark. Pain Med 2015
  32. 32. @EMARIANOMD #WAS2020 Tamboli, et al. Pain Med 2019
  33. 33. @EMARIANOMD #WAS2020 Transitional Pain Katz, et al. J Pain Res 2015 Huang, et al. Pain Manag 2016
  34. 34. @EMARIANOMD #WAS2020 Summary  We discussed “opioid-free anesthesia” and answered the following questions: – How did we get here? – Where is the evidence? – What should we do for our patients?

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