• Alan D Kaye, Sandeep Kandregula, Jennifer Kosty, Anthony Sin, Bharat Guthikonda, G E Ghali, Madelyn K Craig, Alex D Pham, Devin S Reed, Sonja A Gennuso, Rhett M Reynolds, Ken Philip Ehrhardt, Elyse M Cornett, and Richard D Urman.
• Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences Provost, Chief Academic Officer, Vice Chancellor of Academic Affairs, LSU Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA. Electronic address: akaye@lsuhsc.edu.
• Best Pract Res Clin Anaesthesiol. 2020 Jun 1; 34 (2): 255-267.

AbstractThere is an ever-increasing number of opioid users among chronic pain patients and safely managing them can be challenging for surgeons, anesthesiologists, pain experts, and addiction specialists. Healthcare providers must be familiar with phenomena typical of opioid users and abusers, including tolerance, physical dependence, hyperalgesia, and addiction. Insufficient pain management is very common in these patients. Patient-centered preoperative communication is integral to setting realistic expectations for postoperative pain, developing successful nonopioid analgesic regimens, minimizing opioid consumption during the postoperative period, and decreasing the number of opioid pills at the risk of diversion. Preoperative evaluation should identify comorbidities and identify risk factors for substance abuse and withdrawal. Intraoperative and postoperative strategies can ensure safe and effective pain management and minimize the potential for morbidity and mortality in this high-risk patient population.Published by Elsevier Ltd.

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