Multimodal Anesthetic Recommendations for Patients Identified with Chronic Pain Undergoing Major Joint or Neuro-Spine Surgery
Abstract
The purpose of this project was to preoperatively identify chronic pain patients and provide evidence-based perioperative recommendations to enhance surgical outcomes. Will early identification and knowledge of the current state of the evidence lead to a measurable effect for this patient population? Project Design: Phase 1 consisted of the implementation of an early identification pain tool for all patients presenting for surgery over a 60-day period. Phase 2 involved dissemination of evidence-based recommendations for adult chronic pain patients undergoing major joint or neurospine surgeries. Additionally, over the following two months data on time to first opioid, total opioid consumption, and hospital length of stay was analyzed and compared to retrospective data. Analysis of the Results: Perioperative recommendations for major joints resulted in a 54 percent increase in time to first opioid and a 38.5 percent decrease in length of stay. However, a 121 percent increase in morphine equivalent in 24-hours was noted. The neuro-spine population demonstrated similar results with a 71 percent increase in time to first opioid, a 36.3 percent reduction in length of stay, and a 75 percent increased morphine equivalent. This institution showed that greater than 30 percent of all surgical patients reported chronic pain, which is consistent with the national average. Furthermore, chronic pain was demonstrated in other unexpected surgical subspecialties. This highlights the need for early identification and knowledge of the current state of the evidence to effectively care for chronic pain at this institution.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2022
- Accession Number
- AD1186271
Entities
People
- Aria A. Klein
- Edson W. Charles
- Joshua W. Boyle
- Mathew R. Thompson
Organizations
- Uniformed Services University of the Health Sciences