Expanding the Perisurgical Home to Improve Postoperative Pain Management and Reduce Opioid Consumption

Following surgery, effective pain management is an important component of patient recovery and satisfaction. However, the conceptualization of pain as the fifth vital sign has led to a culture of drastic opioid overprescription.1,2 As pain scores and adequate pain management gained attention, the expectation that patients should experience no pain became widely accepted, along with the expectation that postoperative discharge must include an opioid prescription. Moreover, pain became an important factor in comparative analyses of hospitals, even contributing to physician reimbursement. As a result, physicians commonly feel pressured to prescribe an unnecessary amount of opioids to attempt to prevent inadequately controlled pain, emergency department visits, and hospital readmissions. Unsurprisingly, burdened with postoperative pain as a marker of quality, surgeons have become one of the highest prescribers of opioid medications. In the face of the resulting opioid epidemic, however, it is prudent for providers to revisit the topic of postoperative pain control and to reconsider the extent to which opioids play a role