PMID- 30367388
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2193-8237 (Print)
IS  - 2193-651X (Electronic)
VI  - 7
IP  - 2
DP  - 2018 Dec
TI  - Practice Patterns and Treatment Challenges in Acute Postoperative Pain 
      Management: A Survey of Practicing Physicians.
PG  - 205-216
LID - 10.1007/s40122-018-0106-9 [doi]
AB  - INTRODUCTION: The management of acute postoperative pain remains a significant 
      challenge for physicians. Poorly controlled postoperative pain is associated with 
      poorer overall outcomes. METHODS: Between April and May 2017, physicians from an 
      online database who regularly prescribe intravenous (IV) medications for acute 
      postoperative pain completed a 47-question survey on topics such as patient 
      demographics, IV analgesia preferences, factors that influence prescribing 
      decisions, and the challenges and unmet needs for the treatment of acute 
      postoperative pain. RESULTS: Of 501 surveyed physicians, 55% practiced in 
      community hospitals, 60% had been in practice for > 10 years, and 60% were 
      surgeons. The three categories of IV pain medications most likely to be 
      prescribed to patients with moderate-to-severe pain immediately after surgery 
      were morphine, hydromorphone, or fentanyl (95.8% of respondents); COX-2 
      inhibitors or nonsteroidal anti-inflammatory drugs (73.7%); and acetaminophen 
      (60.5%). Past clinical experience (81.6%), surgery type (78.2%), and onset of 
      analgesia (67.1%) were practice-related factors that most determined their 
      medication choice. Key patient-related risk factors, such as avoidance of 
      medication-related adverse events (AEs), each influenced prescription decisions 
      in > 75.0% of physicians. Nausea and vomiting were among the most common 
      challenges associated with postoperative pain management (76.2 and 60.3%, 
      respectively), and avoidance of analgesic medication-related AEs was among the 
      three most influential patient-related factors that determined prescribing 
      decision (75%). Physicians reported the top unmet need for acute pain management 
      in patients experiencing moderate-to-severe postoperative pain was more 
      medications with fewer side effects (i.e., nausea, vomiting, and respiratory 
      depression; 80.7%). CONCLUSIONS: Opioids remain an integral component of 
      multimodal acute analgesic therapy for acute postoperative pain in hospitalized 
      patients. The use of all IV analgesic medications is limited by concerns over 
      AEs, particularly with opioids and in high-risk patients. There remains a key 
      unmet need for effective analgesic medications that are associated with a lower 
      risk of AEs. FUNDING: Trevena, Inc.
FAU - Gan, Tong J
AU  - Gan TJ
AD  - Department of Anesthesiology, Stony Brook University, Stony Brook, NY, USA. 
      tong.gan@stonybrookmedicine.edu.
FAU - Epstein, Robert S
AU  - Epstein RS
AD  - Epstein Health, LLC, Woodcliff Lake, NJ, USA.
FAU - Leone-Perkins, Megan L
AU  - Leone-Perkins ML
AD  - HealthiVibe, LLC, Arlington, VA, USA.
FAU - Salimi, Tehseen
AU  - Salimi T
AD  - Trevena, Inc., King of Prussia, PA, USA.
FAU - Iqbal, Sheikh Usman
AU  - Iqbal SU
AD  - Trevena, Inc., King of Prussia, PA, USA.
FAU - Whang, Peter G
AU  - Whang PG
AD  - Yale University School of Medicine, New Haven, CT, USA.
LA  - eng
GR  - N/A/Trevena Inc./
PT  - Journal Article
DEP - 20181026
PL  - New Zealand
TA  - Pain Ther
JT  - Pain and therapy
JID - 101634491
PMC - PMC6251830
OTO - NOTNLM
OT  - Adverse events
OT  - Analgesia
OT  - Intravenous
OT  - Morphine
OT  - Nausea
OT  - Opioid
OT  - Respiratory depression
OT  - Surgery
OT  - Vomiting
EDAT- 2018/10/28 06:00
MHDA- 2018/10/28 06:01
PMCR- 2018/10/26
CRDT- 2018/10/28 06:00
PHST- 2018/08/07 00:00 [received]
PHST- 2018/10/28 06:00 [pubmed]
PHST- 2018/10/28 06:01 [medline]
PHST- 2018/10/28 06:00 [entrez]
PHST- 2018/10/26 00:00 [pmc-release]
AID - 10.1007/s40122-018-0106-9 [pii]
AID - 106 [pii]
AID - 10.1007/s40122-018-0106-9 [doi]
PST - ppublish
SO  - Pain Ther. 2018 Dec;7(2):205-216. doi: 10.1007/s40122-018-0106-9. Epub 2018 Oct 
      26.