Grant: CIHR Fellowship

Canada, like many other countries, is experiencing an opioid crisis with numerous communities reporting an alarming number of opioid-related deaths. Innovative solutions are urgently needed. Opioids are widely used during surgery to control pain. However, there are problems associated with the use of opioids (nausea, dizziness, dependence), and their use in perioperative care might be counterproductive in terms of patient benefits. Importantly, since more than one million surgeries are performed yearly in Canada, the use of opioids in perioperative care is contributing to the health and social burden associated with opioid use (opioid crisis) as between 6 and 10% of patients will continue to use opioids in the long-term well after their surgery. In that context, alternative drugs to opioids have been proposed. Such alternative drugs could provide benefits in terms of comfort and recovery after surgery, in addition to reducing opioid exposure. However, there are no established guidelines on how best to use these strategies and how they benefit patients. Many "off-label" non-opioid strategies are currently used with potential threat to patient safety. Working with patient partners and decision-makers, my research program will include reviews of all available published literature on studies that assessed drug alternatives to opioids during surgery. These studies will provide us with an overview of which drugs are used during surgery and how they can benefit patients in their recovery, their satisfaction, their quality of life, their functional capacities after surgery as well as long-term use of opioids after surgery. This critical work will help inform a large clinical trial of opioid-minimizing interventions during surgery in adult patients. Our program will help address the burden from the opioid crisis across Canada by reducing potential unnecessary use of opioids during surgery and finding effective alternatives that benefit outcomes important to patients.