Reducing Postop Opioids
In Australia, “Hospitalisations and deaths related to opioid overuse, misuse, or overdose increased by 240% and 180%, respectively, with a corresponding 32-fold increase in yearly public health costs to $271 million AUD within the past 2 decades.” After implementing a single anesthesiologist-led perioperative pain service called POPPMED—perioperative pain management, education, and de-escalation—researchers published their retrospective cohort study findings in Pain Reports. Over 100 patients treated with 50mg oral morphine equivalent daily dosages (OMEDD) preoperatively were provided with behavioral interventions, opioid reductions/rotations, and/or ketamine in order to receive the lowest opioids doses at discharge.
The service identified, preoperatively, patients with risk factors for opioid escalation, including:
- Active preexisting opioid prescription
- Chronic pain
- Recreational drug use
- Opioid replacement therapy.
The study concluded, “POPPMED achieved sustained OMEDD reductions safely in an older, high-risk opioid tolerant population, with analgesia comparable to a non-POPPMED cohort, and surgery specific effects on length of stay.”
Read the journal article.
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