Astrid Leon MD , Justin Robbins MD , Ashley Hughes BA , Oumou Fofana BS , Corinna Crayton MD , Priti P. Parikh PhD , Timothy Crawford PhD , Samantha Shugar MS , Casey Walk MD , Michelle DeGroat MD, FACS , Randy Woods MD, FACS
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引用次数: 0
Abstract
Introduction
The opioid crisis is a major public health issue, and postoperative opioids play a unique role. Many institutions have implemented standardized protocols to decrease excess opioids available. The objective of this study was to establish a standardized pain protocol for common surgical procedures and assess postoperative pain control.
Methods
This is a prospective observational study based on the Michigan Opioid Prescribing Engagement Network network guidelines which provides prescription recommendations for surgical procedures. We evaluated all laparoscopic/robotic cholecystectomy, appendectomy, and all herniorrhaphies. Patients were prescribed a predetermined number of narcotics by procedure as part of a multimodal pain regimen. A survey was conducted within 14 d postoperatively to assess pain control and narcotic utilization.
Results
A total of 442 patients were included from July 1, 2022 to October 28, 2022. Survey response was 40% (178/442) with 56% (249/442) prescribed per protocol. Fewer patients prescribed per protocol required refills, 9.6% (24/249) compared to 18.1% (35/193) (P = 0.007) without protocol. Patients reported taking significantly fewer narcotics with the protocol versus without (median = 5.0 versus 10.0, P < 0.001). The median number of narcotics taken were 5.5 for appendectomy, 7.0 for cholecystectomy, and 9.0 for herniorrhaphy. There was no difference in pain control when comparing patients with and without protocol (91.1% versus 90.5%, P = 1.0).
Conclusions
This study demonstrated that postoperative opioid prescriptions can be decreased by implementing a standardized protocol incorporating a multimodal regimen while adequately controlling pain following surgery.
期刊介绍:
The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories.
The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.