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Feasibility study of an online modifiable Enhanced Recovery After Surgery protocol with specific focus on opioid avoidance
Author(s) -
Ceuppens Charlotte,
DudiVenkata Nagendra N.,
Lee Yanni D.,
Beh Yong Z.,
Bedrikovetski Sergei,
Thomas Michelle L.,
Kroon Hidde M.,
Sammour Tarik
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15976
Subject(s) - medicine , opioid , oxycodone , fentanyl , protocol (science) , retrospective cohort study , medical prescription , anesthesia , population , emergency medicine , surgery , pharmacology , alternative medicine , receptor , environmental health , pathology
Background The high and increasing rate of opioid use is a serious issue in the Western world affecting the population's physical and mental health. In most cases, opioid dependency starts with prescriptions by medical professionals, so efforts aimed at reducing in‐hospital opioid use should result in less long‐term dependency. The aim of the current study was to evaluate the feasibility of implementing an opioid‐scarce protocol as part of a new online modifiable Enhanced Recovery After Surgery (mERAS) programme. Methods A single‐centre retrospective study was conducted comparing a cohort treated under the new opioid‐scarce mERAS protocol ( n = 96; May 2018–Nov 2018) to those treated under the original ERAS protocol ( n = 84; November 2017–April 2018). The primary outcome was the quantity and duration of opioid use. Results Fewer patients used fentanyl via intravenous patient‐controlled analgesia in the mERAS group (54% versus 70%; P = 0.03). The mERAS group was also less likely to use oral oxycodone (80% versus 99%; P < 0.0001) and for a shorter duration (median 3 versus 5 days; P = 0.0002). More local anaesthetic transversus abdominis plane catheters were used in the mERAS group (34% versus 6% in the control group; P < 0.0001). Conclusion Opioid use can be significantly reduced after elective colorectal surgery by employing an opioid‐scarce ERAS protocol. Further data is required to confirm the clinical benefits of this approach.