A multisociety organizational consensus process to define guiding principles for acute perioperative pain management

Edward R Mariano^{1

2}, David M Dickerson^{3

4}, Joseph W Szokol⁵, Michael Harned⁶, Jeffrey T Mueller⁷, Beverly K Philip^{8

9}, Jaime L Baratta¹⁰, Padma Gulur¹¹, Jennifer Robles^{12

13}, Kristopher M Schroeder¹⁴, Karla E K Wyatt^{15

16}, Jason M Schwalb¹⁷, Eric S Schwenk¹⁰, Richa Wardhan¹⁸, Todd S Kim¹⁹, Kent K Higdon²⁰, Deepak G Krishnan^{21

22}, Ashley M Shilling²³, Gary Schwartz^{24

25}, Lisa Wiechmann²⁶, Lisa V Doan²⁷, Nabil M Elkassabany²⁸, Stephen C Yang²⁹, Iyabo O Muse³⁰, Jean D Eloy³¹, Vikas Mehta³², Shalini Shah³³, Rebecca L Johnson³⁴, Michael J Englesbe³⁵, Amanda Kallen³⁶, S Bobby Mukkamala³⁷, Ashley Walton³⁸, Asokumar Buvanendran³⁹

Affiliations

¹ Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA emariano@stanford.edu.
² Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
³ Department of Anesthesiology, Critical Care and Pain Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.
⁴ Department of Anesthesia & Critical Care, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
⁵ Department of Anesthesiology, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
⁶ Department of Anesthesiology, Division of Pain Medicine, University of Kentucky, Lexington, Kentucky, USA.
⁷ Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, Phoenix, Arizona, USA.
⁸ American Society of Anesthesiologists, Schaumburg, Illinois, USA.
⁹ Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁰ Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
¹¹ Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
¹² Department of Urology, Division of Endourology and Stone Disease, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹³ Surgical Service, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
¹⁴ Department of Anesthesiology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA.
¹⁵ Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, Texas, USA.
¹⁶ Department of Anesthesiology, Baylor College of Medicine, Houston, Texas, USA.
¹⁷ Department of Neurological Surgery, Henry Ford Medical Group, Detroit, Michigan, USA.
¹⁸ Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
¹⁹ Department of Orthopedic Surgery, Palo Alto Medical Foundation, Burlingame, California, USA.
²⁰ Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
²¹ Department of Oral & Maxillofacial Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
²² Department of Oral & Maxillofacial Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
²³ Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia, USA.
²⁴ AABP Integrative Pain Care, Brooklyn, New York, USA.
²⁵ Department of Anesthesiology, Maimonides Medical Center, Brooklyn, New York, USA.
²⁶ Department of Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, New York, USA.
²⁷ Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, New York, USA.
²⁸ Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
²⁹ Department of Surgery, Division of Thoracic Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
³⁰ Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, New York, USA.
³¹ Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
³² Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, USA.
³³ Department of Anesthesiology & Perioperative Care, University of California Irvine School of Medicine, Orange, California, USA.
³⁴ Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³⁵ Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
³⁶ Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA.
³⁷ American Medical Association, Chicago, Illinois, USA.
³⁸ American Society of Anesthesiologists, Washington, District of Columbia, USA.
³⁹ Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA.

PMID: 34552003
DOI: 10.1136/rapm-2021-103083

A multisociety organizational consensus process to define guiding principles for acute perioperative pain management

Edward R Mariano et al. Reg Anesth Pain Med. 2022 Feb.

. 2022 Feb;47(2):118-127.

doi: 10.1136/rapm-2021-103083. Epub 2021 Sep 22.

Authors

Affiliations

¹ Anesthesiology and Perioperative Care Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA emariano@stanford.edu.
² Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
³ Department of Anesthesiology, Critical Care and Pain Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.
⁴ Department of Anesthesia & Critical Care, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
⁵ Department of Anesthesiology, University of Southern California Keck School of Medicine, Los Angeles, California, USA.
⁶ Department of Anesthesiology, Division of Pain Medicine, University of Kentucky, Lexington, Kentucky, USA.
⁷ Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Arizona, Phoenix, Arizona, USA.
⁸ American Society of Anesthesiologists, Schaumburg, Illinois, USA.
⁹ Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
¹⁰ Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
¹¹ Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
¹² Department of Urology, Division of Endourology and Stone Disease, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
¹³ Surgical Service, Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
¹⁴ Department of Anesthesiology, University of Wisconsin School of Medicine, Madison, Wisconsin, USA.
¹⁵ Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, Texas, USA.
¹⁶ Department of Anesthesiology, Baylor College of Medicine, Houston, Texas, USA.
¹⁷ Department of Neurological Surgery, Henry Ford Medical Group, Detroit, Michigan, USA.
¹⁸ Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
¹⁹ Department of Orthopedic Surgery, Palo Alto Medical Foundation, Burlingame, California, USA.
²⁰ Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
²¹ Department of Oral & Maxillofacial Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
²² Department of Oral & Maxillofacial Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
²³ Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia, USA.
²⁴ AABP Integrative Pain Care, Brooklyn, New York, USA.
²⁵ Department of Anesthesiology, Maimonides Medical Center, Brooklyn, New York, USA.
²⁶ Department of Surgery, NewYork-Presbyterian/Columbia University Medical Center, New York, New York, USA.
²⁷ Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University Grossman School of Medicine, New York, New York, USA.
²⁸ Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
²⁹ Department of Surgery, Division of Thoracic Surgery, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
³⁰ Department of Anesthesiology, Westchester Medical Center/New York Medical College, Valhalla, New York, USA.
³¹ Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
³² Department of Otolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, USA.
³³ Department of Anesthesiology & Perioperative Care, University of California Irvine School of Medicine, Orange, California, USA.
³⁴ Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
³⁵ Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
³⁶ Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA.
³⁷ American Medical Association, Chicago, Illinois, USA.
³⁸ American Society of Anesthesiologists, Washington, District of Columbia, USA.
³⁹ Department of Anesthesiology, Rush University Medical Center, Chicago, Illinois, USA.

PMID: 34552003
DOI: 10.1136/rapm-2021-103083

Abstract

The US Health and Human Services Pain Management Best Practices Inter-Agency Task Force initiated a public-private partnership which led to the publication of its report in 2019. The report emphasized the need for individualized, multimodal, and multidisciplinary approaches to pain management that decrease the over-reliance on opioids, increase access to care, and promote widespread education on pain and substance use disorders. The Task Force specifically called on specialty organizations to work together to develop evidence-based guidelines. In response to this report's recommendations, a consortium of 14 professional healthcare societies committed to a 2-year project to advance pain management for the surgical patient and improve opioid safety. The modified Delphi process included two rounds of electronic voting and culminated in a live virtual event in February 2021, during which seven common guiding principles were established for acute perioperative pain management. These principles should help to inform local action and future development of clinical practice recommendations.

Keywords: acute pain; analgesics; opioid; pain; pain management; postoperative.

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Conflict of interest statement

Competing interests: JMS declares salary support from Blue Cross Blue Shield of Michigan; research funding from Neuros Medical (Willoughby, OH, USA), Setpoint Medical (Valencia, CA, USA), and Medtronic (Dublin, Ireland; legal consulting for Yates, McLamb and Weyher, LLP (Raleigh, NC, USA). KKKH is a consultant for True Digital Surgery (Goleta, CA, USA). GS is an advisory board member for Dorsal Health (New York, NY, USA) and consultant for Pacira Biosciences (Parsippany-Troy Hills, NJ, USA). SS is a consultant for Masimo (Irvine, CA, USA), Allergan (Dublin, Ireland), and SPR Therapeutics (Cleveland, OH, USA). These companies had absolutely no input into any aspect of the project design, Pain Summit, or manuscript preparation. None of the other authors has any financial interests to declare.

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A multisociety organizational consensus process to define guiding principles for acute perioperative pain management

Affiliations

A multisociety organizational consensus process to define guiding principles for acute perioperative pain management

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Affiliations

Abstract

Conflict of interest statement

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