Did you know that 13% of trauma patients who go home with an opioid prescription will develop opioid dependence? Multimodal pain regimens not only reduce opioid consumption, but also improve pain control. On this episode of the BIG T TRAUMA series, we explore a multimodal approach to pain management...and tackle some surgical dogma along the way.

Hosts:

Patrick Georgoff, MD, Trauma Surgeon, Duke University, @georgoff
Teddy Puzio, MD, Trauma Surgeon, University of Texas Houston
Gabby Hatton, MD, Trauma Surgery fellow, University of Texas Houston

References:
1. Rate and Risk Factors Associated With Prolonged Opioid Use After Surgery: A Systematic Review and Meta-analysis. JAMA Netw Open 2020: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2767637
2. Traumatic injuries and persistent opioid use in the USA: findings from a nationally representative survey. Injury Prevention 2017: https://pubmed.ncbi.nlm.nih.gov/27597400/
3. Ketamine For Acute Pain After Trauma (KAPT): A Pragmatic, Randomized Clinical Trial. J Trauma 2024:
https://pubmed.ncbi.nlm.nih.gov/38689402/
4. EAST PMG: Efficacy and safety of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of acute pain after orthopedic trauma (2023): https://www.east.org/education-resources/practice-management-guidelines/details/efficacy-and-safety-of-nonsteroidal-antiinflammatory-drugs-nsaids-for-the-treatment-of-acute-pain-af
5. Systematic Review and Meta-Analysis of the Association Between Non-Steroidal Anti-Inflammatory Drugs and Operative Bleeding in the Perioperative Period. JACS 2021:
https://pubmed.ncbi.nlm.nih.gov/33515678/
6. Is the use of nonsteroidal anti-inflammatories after bowel anastomosis in trauma safe? J Trauma 2023:
https://pubmed.ncbi.nlm.nih.gov/36728125/
7. University of Texas at Houston Multimodal Pain Guideline: https://med.uth.edu/surgery/acute-trauma-pain-multimodal-therapy/
8. ACS TRAUMA QUALITY PROGRAMS BEST PRACTICES GUIDELINES FOR ACUTE PAIN MANAGEMENT IN TRAUMA PATIENTS: https://www.facs.org/media/exob3dwk/acute_pain_guidelines.pdf

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Big T Trauma Series Ep. 19 - Multimodal Pain Control

Behind The Knife: The Surgery Podcast