Jane CK FITCH, M.S., president of the American Society of Anesthesiologists (ASA), said in a press release, “As guides to patient safety, anesthesiologists want the most effective tests and treatments for their patients, and we want those tests and treatments to meet the most standardized and patient-friendly criteria. The ASA aims to improve patient safety related to anesthesia and pain medications, and this “Choose Wisely” list can have a positive and significant impact on the quality of patient care.” The new list includes the following physician recommendations: 1. Do not recommend opioid analgesics as first-line treatment for chronic non-cancer pain. Consider combination therapy (including non-pharmacologic treatments, such as behavioral and physical therapies) prior to pharmacologic intervention. Prefer non-opioid medications such as NSAIDs and anticonvulsants prior to opioid therapy if pharmacologic indications are evident. 2. Opioid analgesics are not recommended as a long-term treatment for chronic non-cancer pain, especially when their risks are fully considered and before discussing their risks with the patient. Advise that the risks of this treatment include potential addiction toxicity (e.g., urine** testing) and the consequences of not following the principles. Be aware of the combination of opioids with benzodiazepines. Physicians should be proactive in the evaluation and treatment of their patients. If appropriate, the most frequently occurring adverse effects include constipation and lowered androgen or estrogen levels. 3. Avoid imaging tests, such as MRI, computed tomography, and radiography, for acute low-segment low back pain without obvious symptoms. Avoid these interventions within 6 weeks of the onset of low-grade low back pain if there are no obvious clinical symptoms (e.g., history of potentially metastatic cancer, diagnosed aortic aneurysm, and progressive neurologic deficits). Most such pain does not require imaging, as these tests may reveal diverting findings and increase the risk of unhelpful surgery. 4. Do not administer intravenous sedatives. For example, propofol, midazolam, or ultra-short-acting opioid infusions are used as the default practice for diagnostic and therapeutic nerve blocks or joint injections (but this recommendation is not appropriate for pediatric patients). Ideally, diagnostic procedures should be performed under local anesthesia alone. Intravenous sedation may be used after assessment and discussion of risks, including assessment of acute surgical pain relief and potential false positive reactions. Stay tuned as ASA criteria for applying basic anesthesia to detect cases of moderate or deep sedation will be available soon. 5. Avoid irreversible non-cancer pain interventions. Such as peripheral chemical nerve destruction or peripheral radiofrequency ablation. These interventions may be costly and carry a significant long-term risk of weakness, numbness, and increased pain.