Opioid Management in the Setting of Enhanced Recovery After Surgery (ERAS) Protocols

Enhanced Recovery After Surgery (ERAS) protocols have been implemented across multiple surgical specialties, including OB/GYN, to improve patients' perioperative experiences. ERAS protocols typically include multimodal pain regimens; opioids are frequently utilized. In the perioperative setting, nonopioid analgesics, including acetaminophen, NSAIDs, dexamethasone, gabapentinoids, ketamine, antidepressants, and local anesthesia may be used, which impacts perioperative opioid utilization. In some patients, opioid-sparing analgesia may be possible. Postdischarge, patients should utilize a multimodal pain regimen similar to that of their inpatient stay, with limited opioid quantities prescribed. Postoperative prescribing should balance optimal pain control while considering the risks and side effects of opioid analgesics.