The Standardization of Outpatient Procedure (STOP) Narcotics after anorectal surgery: a prospective non-inferiority study to reduce opioid use

Autor: J A M Van Koughnett, Collin Clarke, Ken Leslie, Allison H. Maciver, Patrick B. Murphy, Luke B. Hartford, Daryl K. Gray, C Garcia-Ochoa, Laura J. Allen
Rok vydání: 2020
Předmět:
Zdroj: Techniques in Coloproctology. 24:563-571
ISSN: 1128-045X
1123-6337
Popis: Prescription of opioid medication after ambulatory anorectal surgery may be excessive and lead to opioid misuse. The purpose of this study was to evaluate the efficacy of a multi-modality opioid-sparing approach to control postoperative pain and reduce opioid prescriptions after outpatient anorectal surgery. A prospective non-inferiority pre- and post-intervention study was completed at three academic hospitals. Patients included were 18–75 years of age who had outpatient anorectal surgeries. The Standardization of Outpatient Procedure (STOP) Narcotics intervention was implemented, which is a multi-pronged analgesia bundle integrating patient education, health care provider education, and intra-/postoperative analgesia focused on multi-modal pain control strategies and opioid-reduced prescriptions. The primary outcome was patient-reported average pain in the first 7 postoperative days. Secondary outcomes included patient-reported quality of pain management, medication utilization, prescription refills and medication disposal. Ninety-three patients had outpatient anorectal surgery (42 pre-intervention and 51 post-intervention). No difference was seen in average postoperative pain in the pre- vs. post-intervention groups (2.8 vs. 2.6 on an 11-point scale, p = 0.33) or patient-reported quality of pain control (good/very good in 57% vs. 63%, p = 0.58). The median oral morphine equivalents (OME) prescribed was significantly less [112.5 (IQR 50–150) pre-intervention vs. 50 (IQR 50–50) post-intervention, p
Databáze: OpenAIRE
Externí odkaz: