Your browser doesn't support javascript.
Reduced Opioid Use and Prescribing in a Same Day Discharge Pilot Enhanced Recovery Program for Elective Minimally Invasive Colorectal Surgical Procedures During the COVID-19 Pandemic.
Tran-McCaslin, Marie; Basam, Motahar; Rudikoff, Andrew; Thuraisingham, Dhilan; McLemore, Elisabeth C.
  • Tran-McCaslin M; Department of Surgery, 23543Kaiser Permanente - Los Angeles Medical Center, Los Angeles, CA, USA.
  • Basam M; Department of Surgery, 23543Kaiser Permanente - Los Angeles Medical Center, Los Angeles, CA, USA.
  • Rudikoff A; Department of Anesthesia, 23543Kaiser Permanente - Los Angeles Medical Center, Los Angeles, CA, USA.
  • Thuraisingham D; Department of Anesthesia, 23543Kaiser Permanente - Los Angeles Medical Center, Los Angeles, CA, USA.
  • McLemore EC; Department of Surgery, 23543Kaiser Permanente - Los Angeles Medical Center, Los Angeles, CA, USA.
Am Surg ; 88(10): 2572-2578, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1909979
ABSTRACT

PURPOSE:

Enhanced recovery pathways (ERPs) are associated with reduced complications and length of stay. The validation of the I-FEED scoring system, advances in perioperative anesthesia, multimodal analgesia, and telehealth remote monitoring have resulted in further evolution of ERPs setting the stage for same day discharge (SDD). Pioneers and early adopters have demonstrated the safety and feasibility of SDD programs. The aim of this study is to evaluate the impact of a pilot SDD ERP on patient self-reported pain scoring and narcotic usage.

METHODS:

A quality improvement pilot program was conducted to assess the impact of a SDD ERP on post-operative pain score reporting and opioid use in healthy patients undergoing elective colorectal surgery as an alternative to post-operative hospitalization during the COVID-19 pandemic (May 2020-December 2021). Patients were monitored remotely with daily telephone visits on POD 1-7 assessing the following variables I-FEED score, pain score, pain management, bowel function, dietary advancement, any complications, and/or re-admissions.

RESULTS:

Thirty-seven patients met the highly selective eligibility criteria for "healthy patient, healthy anastomosis." SDD occurred in 70%. The remaining 30% were discharged on POD 1. Mean total narcotic usage was 5.2 tablets of 5 mg oxycodone despite relatively high reported pain scores.

CONCLUSIONS:

In our initial experience, SDD is associated with significantly lower patient narcotic utilization for postoperative pain management than hypothesized. This pilot SDD program resulted in a change in clinical practice with reduction of prescribed discharge oxycodone 5 mg quantity from #40 to #10 tablets.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / COVID-19 / Opioid-Related Disorders Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Am Surg Year: 2022 Document Type: Article Affiliation country: 00031348221109467

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Colorectal Neoplasms / COVID-19 / Opioid-Related Disorders Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Am Surg Year: 2022 Document Type: Article Affiliation country: 00031348221109467