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Special Issue Title:

Opioid Sparing Modalities in Perioperative and Critical Care Patients: opioids sparing analgesia pain perioperative

Deadline for manuscript submissions: 28 March 2022

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Special Issue Editor

  • Guest Editor

    Dr. Michael O’Neil, Pharm.D.E-MailWebsite

    Professor and Chair Department of Pharmacy Practice Drug Diversion, Substance Abuse and Pain Management Consultant South College School of Pharmacy, Knoxville, Tennessee, United States

    Interests: Drug Diversion, Substance Use Disorders, Critical Care Management, Pain Management

Special Issue Information

In spite of a variety of efforts to mitigate opioid misuse, prescription opioids remain one of the leading contributors in the current opioid epidemic. Opioid prescribing has increased substantially over the past two decades in the United States. However, more recent trends indicate the number of prescriptions for opioid has begun to decrease. The prescribing of opioids has contributed substantially to increases in overdoses, the need for addiction treatment, and overdose death. Recent data has indicated use of prescription opioids greater than a few days increases the risk of opioid dependence and misuse. Many states, as well as professional organizations, have developed opioid prescribing guidelines in an attempt to minimize unnecessary opioid prescribing and to minimize leftover medications that may potentially be misused or diverted. 

Although guidelines and state regulations have started to limit prescribing, the management of moderate-to-severe postsurgical pain often remains difficult requiring high dose or prolonged use of opioids. A plethora of factors influence analgesic management in postoperative patients. Some of these include, but are not limited to, type of surgery, types of pain requiring treatment, severity of pain, co-occurring medical conditions, medication-disease interactions, medication-medication interactions, medication misuse history, risk of medication diversion, medication adherence, and cost.

A variety of perioperative strategies have aimed to minimize opioid use. Some of these include anesthetic techniques within the neuraxial system such as local nerve blocks, combinations of nonopioid analgesics like ketamine or clonidine, and alternative routes of medication administration. Perioperative strategies may include interventions performed immediately before the procedure, during the operative procedure, immediately following the procedure while in the hospital, and after discharge at home. Each of these perioperative phases has advantages and limitations that must be considered. For example, routes of medication administration such as intravenous or epidural require trained personnel compared to post discharge oral medications. Skill levels for monitoring patient analgesia response and potential adverse effects also vary significantly.

Regardless of the need to prescribe less opioids, these interventions may limit opioid analgesia intraoperatively, postoperatively in-hospital, and possible after discharge home. This special edition series will focus on the various roles of opioid sparing modalities in perioperative and intensive care patients.


Opioid misuse, Prescription opioids, Postsurgical pain, Perioperative strategies, Critical care

Manuscript Submission Information

Manuscripts should be submitted online by submit system. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Original articles, case reports or comprehensive reviews are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website. Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a double-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Signa Viate is an international peer-reviewed open access journal published by MRE Press. As of January 2021, Signa Vitae will change to a bimonthly journal. Please visit the Instructions for Authors page before submitting a manuscript.The Article Processing Charge (APC) for publication in this open access journal is $1200. We normally offer a discount greater than 30% to all contributors invited by the Editor-in-Chief, Guest Editor (GE) and Editorial board member. Submitted papers should be well formatted and use good English.

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