Use of Multi-Modal Pain Medication Clinical Practice Guideline to Decrease Opioid Use in Post Cardiac Surgical Patients
Keywords:Opioids in cardiac surgery
reducing opioid use after surgery
inpatient opioid stewardship
ERAS in cardiac surgery
Multimodal pain medication
MetadataShow full item record
Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
The overuse and abuse of opioids and subsequent health risks, including death due to overdose, have reached epidemic proportions in the United States. Pain management after cardiac surgical procedures can contribute to overuse of opioids. Alternate strategies that decrease the patient use of opioids for post-cardiac surgery pain management are necessary to mitigate the risks of dependence. A literature review showed that a multi-modal approach to cardiac post-operative pain management, a single element of Early Recovery After Surgery (ERAS), results in decreased opioid use post-operatively, and may have positive affects on other opioid related risks such as ventilation time, ventilator acquired pneumonia, and gastrointestinal complications. The project focused on implementation of a post-operative multi-modal pain management clinical guideline to decrease the rate of opioid consumption in the open-heart surgical patient population. The statistically significant drop in overall opioid consumption revealed the clinical guideline to be effective in decreasing opioid consumption in the post-operative period, while there was no net effect on ventilation times. Additional investigation to examine the effects that decreased inpatient opioid intake has, if any, on post-discharge opioid prescription practices and patient use is recommended to further understand the impact on opioid consumption following open heart surgery.
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