A problem we are encountering more and more is the post op patient(in the PACU and beyond) who is on vicodin or Norco or something similar for months or even years who then has surgery. WHOA! They are soooo difficult to manage pain wise. Is there a protocol or suggestions for this because our anesthesiologists and surgeons are clueless about this. We need to have a better plan than constantly medicating like crazy to play catch up so the patient stops screaming(literally). These are NOT what people call drug seekers, they simply have an extrodinarily high threshold for narcotics due to the long term use.
Are there things they can take pre-op that may help? Any insight would be great. Thanks.