Perioperative Pain Management Protocol Builder
Build evidence-based perioperative pain protocols with risk stratification and multimodal optimiz...
What You Can Do
You can create comprehensive, evidence-based perioperative pain management protocols tailored to individual patient characteristics and surgical requirements. The skill assesses patient risk factors, recommends optimized multimodal analgesia regimens with specific drug selections and dosing rationales, incorporates regional techniques when appropriate, and identifies contingency plans for inadequate pain control or contraindications. This enables you to move beyond generic guidelines toward truly personalized pain management strategies that reduce opioid exposure while maintaining analgesia.
Features
assesses patient comorbidities, substance use history, renal/hepatic function, and sleep apnea to identify high-risk pain management considerations
recommends evidence-based drug combinations (NSAIDs, acetaminophen, regional blocks, gabapentinoids, ketamine, dexamethasone) with specific dosing and timing
factors in drug clearance, metabolism, and interactions for patients with organ dysfunction or polypharmacy
suggests appropriate regional anesthesia or peripheral nerve blocks to enhance analgesia and reduce systemic opioid requirements
identifies drug class restrictions and recommends safe alternatives based on patient allergies, renal/hepatic disease, or other limitations
specifies medication timing and transitions to optimize pain control through recovery phases
prioritizes non-opioid and regional techniques to minimize opioid exposure while maintaining adequate analgesia
outlines escalation plans and alternative regimens if initial strategy proves inadequate
Example Output
Example 1: Obese patient with sleep apnea undergoing major abdominal surgery
- Preoperative assessment identifies high aspiration and respiratory depression risk
- Protocol recommends: Liposomal bupivacaine epidural catheter, acetaminophen 1g Q6H, celecoxib 200mg BID (if no renal disease), dexamethasone 8mg at induction, intraoperative ketamine 0.5 mg/kg, limited perioperative opioids with close monitoring
- Postoperative plan includes epidural analgesia continuation, multimodal regimen, and ICU-level monitoring given comorbidities
Example 2: Patient with chronic opioid use disorder undergoing orthopedic surgery
- Risk stratification identifies tolerance, potential withdrawal, and substance use disorder complications
- Protocol recommends: Peripheral nerve blocks (interscalene or femoral), continued home opioid dose (separate from perioperative dosing), multimodal non-opioid regimen, early pain psychology/palliative medicine consultation
- Specifies coordination with addiction medicine and clear communication regarding perioperative opioid strategy
Example 3: Elderly patient with renal impairment undergoing urologic procedure
- Identifies reduced drug clearance, increased delirium risk from CNS-active agents
- Protocol avoids morphine, recommends: Regional anesthesia when feasible, acetaminophen dosing adjusted for renal function, NSAIDs contraindicated, gabapentin dose reduced, short-acting opioids (remifentanil, fentanyl) with careful titration
What's Included
- SKILL.md instruction file: complete skill definition and usage guidelines
- Perioperative Risk Assessment Template: structured checklist for patient comorbidities, contraindications, and analgesic considerations
- Multimodal Regimen Selection Framework: evidence-based drug category combinations with dosing ranges and timing sequences
- Regional Technique Decision Tree: flowchart for identifying appropriate regional blocks based on surgery type and patient factors
- Protocol Documentation Worksheet: structured format for recording preoperative, intraoperative, and postoperative pain management plans with contingencies
Who It's For
- Anesthesiologists designing perioperative pain management for complex or high-risk patients
- Certified Registered Nurse Anesthetists (CRNAs) developing individualized pain protocols
- Acute pain services managing inadequate postoperative pain control or transitioning patients
- Anesthesia departments creating standardized protocols for high-volume procedure types (orthopedic, bariatric, cardiac)
- Perioperative medicine consultants coordinating pain management for medically complex surgical patients
Best For
- Developing preoperative pain plans for obese, sleep apneic, or medically complex patients
- Creating multimodal analgesia regimens for major surgical procedures with opioid-sparing goals
- Managing pain in patients with contraindications to standard analgesics (renal/hepatic disease, NSAIDs intolerance)
- Planning regional techniques and peripheral nerve blocks integrated with systemic multimodal therapy
- Troubleshooting inadequate postoperative pain control and designing escalation protocols
- Coordinating pain management for patients with chronic pain or opioid use disorder
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