The effectiveness of acute pain management for opioid tolerant or opioid dependent patients: a systematic review protocol.

Abstract

REVIEW QUESTION / OBJECTIVE What is the effectiveness of strategies and interventions to manage acute pain in patients who are identified as having a tolerance to or dependence on opioids? The objective of the review is to establish the effectiveness of pharmacological and non-pharmacological strategies and interventions to manage acute pain in patients who are identified as having a tolerance to or dependence on opioids. INCLUSION CRITERIA Types of participants This review will consider studies that include patients over the age of 18 years who have presented to a hospital or health care facility requiring management for acute pain, and are identified within the studies as having a dependence or tolerance to opioids. This includes but is not limited to patients with a history of: Dependence or tolerance of opioids Recreational opioid use Substance addiction Opioid replacement therapy. Patients may have a history of chronic pain or cancer pain; however the pain being treated must also be classified as new in diagnosis and not an increase of pre-existing pain. Patients who are classified as palliative will be excluded from the systematic review. Types of intervention(s) This review will consider studies that focus on interventions and strategies aimed at effectively managing acute pain in opioid tolerant patients. Interventions and strategies may include but are not limited to: Types/combinations of analgesia which may include: morphine, semisynthetic derivatives such as oxycodone and hydromorphone and totally synthetic derivatives such as fentanyl and methadone. Combinations of opioids and non-opioids; non-opioids will also be considered Patient TRUNCATED AT 250 WORDS