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This article has been peer reviewed. It is the authors' final version prior to publication in Anesthesiology Clinics

Volume 34, Issue 2, June 2016, Pages 287-301.

The published version is available at DOI: 10.1016/j.anclin.2016.01.005. Copyright © W.B. Saunders


Management of acute postoperative pain is important to decrease perioperative morbidity and improve patient satisfaction. Opioids are associated with potential adverse events that may lead to significant risk. Uncontrolled pain is a risk factor in the transformation of acute pain to chronic pain. Balancing these issues can be especially challenging in opioid-tolerant patients undergoing surgery, for whom rapidly escalating opioid doses in an effort to control pain can be associated with increased complications. In the perioperative surgical home model, anesthesiologists are positioned to coordinate a comprehensive perioperative analgesic plan that begins with the preoperative assessment and continues through discharge.

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