CME expires July 31, 2028

Go beyond traditional learning with a 360° perspective on orthopedic topics.

Each ICL360 is a cutting-edge CME course designed to provide a holistic learning experience, featuring curated video content sourced from expert-selected Instructional Course Lectures enhanced with insightful commentary and comprehensive assessment questions. This all-encompassing course goes beyond traditional learning by offering a complete 360° perspective on orthopedic topics. Explore additional resources, including full-text readings from the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), technique videos from Orthopaedic Video Theater (OVT), and links to external literature and PubMed. Elevate your clinical decision-making skills and gain a well-rounded understanding of essential orthopedic concepts with ICL360.

This Instructional Course Lecture (ICL) examines evidence-based strategies for managing postoperative pain while minimizing opioid use.

Editor 
Liz Dailey, MD, FAAOS

Learning Objectives

• Evaluate preoperative risk factors, such as opioid use, substance use disorders, mental health conditions, and chronic pain, that may increase the risk of prolonged postoperative opioid use.
• Apply patient education strategies to effectively communicate the risks of opioid misuse and the importance of preoperative multimodal pain management using various educational tools, such as multimedia presentations, handouts, and verbal counseling.
• Demonstrate effective pain management strategies via multimodal analgesia (eg, acetaminophen, NSAIDs, and local anesthetic agents) to minimize opioid consumption while maintaining adequate postoperative pain control.
• Use regional anesthesia techniques (eg, interscalene block, lumbar plexus block) in collaboration with anesthesiologists to effectively reduce the perioperative need for opioid medications.
• Screen patients for opioid use disorders via appropriate tools and criteria, such as the CAGE questionnaire or modified versions, to assess risk and tailor pain management strategies.
• Recognize the importance of psychological and social factors, such as anxiety, depression, and social support, in influencing postoperative pain and opioid use, and collaborate with other healthcare providers (eg, mental health specialists, pain management experts) for comprehensive care. 
• Incorporate harm reduction practices by co-prescribing naloxone with opioids for at-risk patients, enhancing patient safety and reducing the risk of overdose.
• Adopt an individualized approach to opioid stewardship that includes adjusting opioid prescriptions based on patient needs, surgical complexity, and preoperative opioid use patterns, ensuring that prescription levels are as low as necessary to maintain comfort.
• Track and evaluate the effectiveness of opioid stewardship protocols in reducing opioid consumption and improving patient satisfaction while ensuring that proper follow-up care is provided to manage potential opioid use disorders.

Earn up to 5 AMA PRA Category 1 CME credits™.