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IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-03-24 DOI:10.1016/j.amjsurg.2025.116299

Adam Timothy Lucy , Angela Danielle Sickels , Elise Aucoin Dasinger , Laura M. Leal , Lauren Caldwell Tanner , Virginia Strickland Pierce , Sabrina D. Goddard , Mohammad Zain Hashmi

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引用次数: 0

摘要

背景有效的疼痛管理同时限制阿片类药物可优化手术护理。急诊普外科（EGS）患者属于易感人群，被排除在强化康复路径之外。我们研究了针对 EGS 的标准化疼痛控制医嘱集的效果。方法将跨专业设计的阿片类药物协议嵌入入院医嘱集。从2019年1月至2023年6月，对所有EGS患者的口服和静脉注射吗啡毫克当量（MME）进行监测，并比较实施前后的情况。主要结果是总吗啡毫克当量和每次阿片类药物剂量的吗啡毫克当量。结果每位患者的总 MME 和每剂量平均 MME 显著下降，并且在所有给药途径中均保持不变。订购的 MME 较低的药物和多模式疗法有所增加。疼痛评分稳定。结论标准化疼痛管理方案减少了 EGS 患者院内阿片类药物的使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Standardized electronic order sets decreases inpatient opioid use in emergency general surgery

Background

Effective pain management while limiting opioids optimizes surgical care. Emergency general surgery (EGS) patients are a vulnerable population and are excluded from enhanced recovery pathways. We examined the effect of standardized pain control order sets for EGS.

Methods

An interprofessionally designed opioid protocol was embedded into admission order sets. Oral and IV morphine milligram equivalents (MME) were monitored from Jan 2019–Jun 2023 for all EGS patients and comparted pre and post-implementation. Primary outcome was total MME and MME per opioid dose administered. Secondary outcomes were pain scores and formulation trends.

Results

Total MME per patient and average MME per dose per patient decreased significantly and were sustained for all administration routes. Lower MME medications were ordered and multimodal regimens increased. Pain scores were stable. MME reduction was sustained over time.

Conclusion

Standardized pain management protocols decreased in-hospital opioid use in EGS.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.