Category: Federal Forum Posters
Purpose: Multimodal analgesia has been increasingly considered routine practice post-surgically. The American Pain Society published postoperative pain management guidelines recommending this practice to reduce postoperative complications, length of stay, and opioid prescriptions. Enhanced recovery after surgery (ERAS) protocols were developed for a standardized approach to perioperative management of joint arthroplasties resulting in clinical and economic benefits. The purpose of this project is to assess adherence to guideline recommendations for postoperative knee/hip arthroplasties and hip fracture repairs. Secondary objectives are to perform an internal quality audit on ERAS protocol usage and design and implement evidence-based, multimodal perioperative analgesia protocol or quick-order menu.
Methods: This project will be a retrospective review of uncomplicated primary knee/hip arthroplasties and hip fracture repairs use of multimodal analgesia to determine adherence to American Pain Society guidelines from January 1, 2018 to March 31, 2018 and audit of ERAS pathways. Data will be collected from the Computerized Patient Record System including age, gender, weight, preoperative serum creatinine and calculated creatinine clearance, preoperative liver function tests, allergies to pain medication(s), smoking status, alcohol use status, history/current of opioid use disorder, preoperative opioid use and indication, preoperative opioid indication, preoperative morphine equivalent daily dose (MEDD), most recent recorded preoperative pain score, psychiatric comorbidities, respiratory comorbidities, gastrointestinal comorbidities, surgical indication, type of surgery, postoperative serum creatinine and calculated creatinine clearance, postoperative liver function tests, postoperative opioid use, postoperative MEDD, number of postoperative multimodal analgesics used, first postoperative pain score recorded, opioid related adverse events, postoperative hospital length of stay, postoperative analgesics prescribed, naloxone kit prescribed within one year of procedure, and 6-week and 3-month follow up pain scores. Descriptive statistics will be utilized. ERAS audit will be conducted via checklist query.
Nayma Moya Romero– PGY1 Pharmacy Resident, West Palm Beach VA Medical Center, Greenacres, FL