Perioperative Opioids, the Opioid Crisis, and the Anesthesiologist

Daniel B. Larach, M.D., M.S.T.R., M.A.; Jennifer M. Hah, M.D., M.S.; Chad M. Brummett, M.D


Anesthesiology. 2022;136(4):594-608. 

In This Article

Abstract and Introduction


From April 2020 through April 2021, 75,673 Americans died from opioid overdoses. Nearly one quarter of the deaths directly involved prescription opioids.[1] This represents the first time mortality has exceeded 75,000 in a 12-month period. Moreover, many people who abuse heroin and fentanyl begin opioid use with a prescription pill.[2] Both the lay and academic presses have focused considerable attention on the misuse and abuse of opioid medications. However, many anesthesiologists may not understand the role perioperative anesthesia practice and pain medicine can play in addressing this issue. In this review, we summarize current evidence related to perioperative opioid administration. We also make suggestions for how anesthesiologists can reduce opioid-related harm and bring value to their healthcare systems. Finally, we provide some caveats to these suggestions given existing gaps in research and highlight areas for future research.