{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T05:22:34Z","timestamp":1788067354842,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"9pt2","license":[{"start":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T00:00:00Z","timestamp":1346889600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,9]]},"abstract":"The majority of patients who undergo surgery will require drug therapy for the management of acute postsurgical pain. Effective control of acute postsurgical pain is essential for the patient not only in the short term but also in the long term to prevent the development of chronic pain, which can occur if early acute pain is prolonged. Currently, opioid analgesics are widely used for the management of acute postsurgical pain. Although opioids provide effective postsurgical pain relief, their use is associated with a number of risks, including the development of opioid\u2010related adverse drug events (ORADE<\/jats:styled-content>s). This review investigates the prevalence of opioid use in the postsurgical setting, the incidence of ORADE<\/jats:styled-content>s, and the impact of these ORADE<\/jats:styled-content>s on patient outcomes, length of stay, and costs after common surgeries. According to a national analysis of ORADE<\/jats:styled-content> incidence, almost 20% of patients treated with opioids experienced an ORADE, with the<\/jats:styled-content> most common being gastrointestinal effects, central nervous system<\/jats:styled-content> effects, pruritus, or urinary retention. Studies show that the risk of developing an ORADE<\/jats:styled-content> is higher in patients receiving higher doses of opioids and in patients undergoing orthopedic or gynecologic surgery compared with patients undergoing general surgery. Elderly patients and those with comorbidities (e.g., obesity, sleep apnea, respiratory disease, urinary disorders) may be particularly vulnerable to ORADE<\/jats:styled-content> development. Both hospital costs and length of stay<\/jats:styled-content> are increased in patients with an ORADE<\/jats:styled-content> versus those without an ORADE.<\/jats:styled-content> Strategies to reduce the use of opioids after surgery are likely to result in positive outcomes by reducing the incidence of ORADE<\/jats:styled-content>s and, as a result, reducing treatment costs associated with surgery and improving patient care.<\/jats:p>","DOI":"10.1002\/j.1875-9114.2012.01177.x","type":"journal-article","created":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T17:05:55Z","timestamp":1346951155000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Challenges in the Management of Acute Postsurgical Pain"],"prefix":"10.1002","volume":"32","author":[{"given":"Gary","family":"Oderda","sequence":"first","affiliation":[{"name":"Pharmacotherapy Outcomes Research Center University of Utah College of Pharmacy Salt Lake City Utah."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,9,6]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"1","article-title":"National hospital discharge survey: 2007 summary","volume":"29","author":"Hall MJ","year":"2010","journal-title":"Natl Health Stat Report"},{"key":"e_1_2_6_3_1","first-page":"1","article-title":"Ambulatory surgery in the United States, 2006","volume":"28","author":"Cullen KA","year":"2009","journal-title":"Natl Health Stat Report"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000068822.10113.9E"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199511000-00023"},{"key":"e_1_2_6_6_1","first-page":"469","volume-title":"Patient safety and quality: an evidence\u2010based handbook for nurses","author":"Wells N","year":"2008"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200010000-00038"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68700-X"},{"key":"e_1_2_6_9_1","volume-title":"VHA\/DoD clinical practice guideline for the management of postoperative pain","author":"Veterans Health Administration","year":"2002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/15360280903544877"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(02)00691-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H386"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1054\/jpai.2002.123652"},{"key":"e_1_2_6_14_1","unstructured":"National Opioid Use Guideline Group (NOUGG).Canadian guideline for safe and effective use of opioids for chronic non\u2010cancer pain 2010."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpain.2004.07.011"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2010.12.001"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq312"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31820d9b76"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200831050-00002"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.143.6.551"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.12.041"},{"key":"e_1_2_6_22_1","first-page":"1","article-title":"Postoperative respiratory depression and opioids","volume":"1","author":"Overdyk FJ","year":"2009","journal-title":"Initiatives Safe Patient Care"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470200059035"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1310\/hpj4404-312"},{"key":"e_1_2_6_25_1","unstructured":"OderdaGM GanT\u2010J RobinsonSB.Opioid\u2010related adverse events increase length of stay and drive up total cost of care in a national database of postsurgical patients. 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