Pain medicine : the official journal of the American Academy of Pain Medicine
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Opioids represent an important analgesic option for physicians managing acute pain in surgical patients. Opioid management is not without its drawbacks, however, and current trends suggest that opioids might be overused in the United States. An expert panel was convened to conduct a clinical appraisal regarding the use of opioids in the perioperative setting. ⋯ Opioids remain a key component of multimodal perioperative analgesia, and strategic opioid use based on clinical considerations and patient-specific needs represents an opportunity to support improved postoperative outcomes and satisfaction. Future studies should focus on identifying optimal procedure-specific and patient-centered approaches to multimodal perioperative analgesia.
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The specific link between obstructive sleep apnea (OSA) and pain is unknown, but it has been hypothesized that OSA patients are hyperalgesic because of fragmented sleep and hypoxemia that enhance sensitivity to pain, promote inflammation, and increase spontaneous pain. We conducted a systematic review of the literature assessing whether OSA is a risk factor for subjective pain intensity and experimental pain tolerance and threshold. ⋯ This systematic review summarizes the current evidence for the association of OSA and pain outcomes. Further research is needed to identify the differential effects of nocturnal hypoxemia and fragmented sleep on pain intensity. Clinicians might consider screening patients with chronic pain for OSA.