Postoperative pain management in patients with preexisting opioid dependence-A scoping review protocol.

Background: Opioid-dependent patients with chronic pain conditions present a significant challenge for anesthesiologists when managing acute postsurgical pain. Opioid-dependent patients can experience tolerance, physical dependence, and hyperalgesia. These patients have an increased risk of poorly managed acute postoperative pain, which can ultimately lead to suffering and potentially an overall increase in length of hospitalization and healthcare cost. However, this is an under-researched field. This scoping review aims to investigate effective strategies in managing postoperative pain in patients with preexisting opioid dependence.

Methods: A scoping review will be conducted on postoperative pain management in patients with preexisting opioid dependence. This review will be prepared according to the JBI methodology for scoping reviews and to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). We will conduct a comprehensive search across multiple databases. Backward citation searching of the final included articles will also be conducted. Data extraction will include trial and participant characteristics, intervention details, and reported outcomes.

Results: In the final review the results will be presented as a descriptive summary with supplementary tables, figures, and graphs where applicable.

Conclusion: The planned scoping review will map out the current evidence about effective strategies to manage postoperative pain in patients with preexisting opioid dependence. We will aim to identify research gaps that can be used as support in the development of further research.