Table 2.

Recommendations for best practice management of pain patients.

1)“Infection control” in healthcare settings according to Center of Disease Control (CDC) recommendations: triage points with body temperature check, social distancing, hand hygiene, face mask and gloves during patient care, and cleaning of surfaces in the patient care environment.

2)Triage the risk of COVID-19 screening patients and personnel for symptoms of COVID-19.

3)Triage the pain procedures in elective, urgent, and emergent situations: suspend elective cases, proceed with emergent ones, and consider case by case in urgent situation.

4)Suspend in-person visits whenever possible. In-person visit remains an option that should be taken into consideration according to several factors, such as acuity and severity of pain, whether or not the patient has comorbid psychiatric condition, occupational consideration (such as whether the patient is also a caregiver or has children), the likelihood of the visit/procedure providing meaningful benefit, the likelihood of the patient to seek emergency services, or be started on opioids, and the need for physical examination.

5)Adapt ongoing therapy to reduce the risk on COVID-19.

6)Perform urgent procedures with the minimal number of personnel, ideally by a single physician avoiding deep sedation requiring airway support.

7)Consider intrathecal pump refill as an emergent interventional pain procedure. In some cases, in–home pump refill can be planned.