Background: Pain continues to be the most common medical concern, and perioperative
health care providers are encountering increasing numbers of patients with chronic pain conditions.
It is important to have a clear understanding of how long-term use of pain medications impacts
anesthesia during the intraoperative and postoperative periods.
Objective: To review common medications used to treat chronic pain and summarize current recommendations
regarding perioperative care.
Method: We reviewed the literature by searching PubMed and Google Scholar for articles from
2000-2016. The search strategy included searching for the various classes of pain medications and
including the terms perioperative, anesthesiology, and recommendations. We also reviewed the
reference lists of each article to identify other relevant sources regarding the perioperative management
of pain medications.
Results: After the literature review, we were able to establish the pharmacology, anesthetic interactions,
and recommendations for management of each of the common classes of pain medication.
Conclusion: Management of postoperative pain is an important concern for all perioperative health
care providers. Although most pain medications should be continued in the perioperative period, it
is important to preoperatively discontinue those that antagonize pain receptors to avoid significant
postoperative morbidities associated with poorly managed pain.