Multimodal analgesia reduces opioid requirements in trauma patients with rib fractures
| Autor: | Burton, Shakira W, Riojas, Christina, Gesin, Gail, Smith, Charlotte B, Bandy, Vashti, Sing, Ronald, Roomian, Tamar, Wally, Meghan K, Lauer, Cynthia W, PRIMUM Group |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male Analgesics Physicians' Rib Fractures multimodal pain regimen Pain Research Clinical Sciences Neurosciences prescribing Evaluation of treatments and therapeutic interventions Opioid Practice Patterns Nursing Cardiorespiratory Medicine and Haematology Emergency & Critical Care Medicine Good Health and Well Being Trauma Centers Clinical Research 6.1 Pharmaceuticals Humans Pain Management Female Analgesia PRIMUM Group |
| Zdroj: | The journal of trauma and acute care surgery, vol 92, iss 3 |
| Popis: | BackgroundRib fractures are common in trauma patients and are associated with significant morbidity and mortality. Adequate analgesia is essential to avoid the complications associated with rib fractures. Opioids are frequently used for analgesia in these patients. This study compared the effect of a multimodal pain regimen (MMPR) on inpatient opioid use and outpatient opioid prescribing practices in adult trauma patients with rib fractures.Study designA pre-post cohort study of adult trauma patients with rib fractures was conducted at a Level I trauma center before (PRE) and after (POST) implementation of an MMPR. Patients on long-acting opioids before admission and those on continuous opioid infusions were excluded. Primary outcomes were oral opioid administration during the first 5 days of hospitalization and opioids prescribed at discharge. Opioid data were converted to morphine milligram equivalents (MMEs).ResultsSix hundred fifty-three patients met inclusion criteria (323 PRE, 330 POST). There was a significant reduction in the daily MME during the second through fifth days of hospitalization; and the average inpatient MME over the first five inpatient days (23 MME PRE vs. 17 MME POST, p = 0.0087). There was a significant reduction in the total outpatient MME prescribed upon discharge (322 MME PRE vs. 225 MME POST, p = 0.006).ConclusionThe implementation of an MMPR in patients with rib fractures resulted in significant reduction in inpatient opioid consumption and was associated with a reduction in the quantity of opiates prescribed at discharge.Level of evidenceTherapeutic/Care Management; level IV. |
| Databáze: | OpenAIRE |
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