Use of Multi-Modal Pain Medication Clinical Practice Guideline to Decrease Opioid Use in Post Cardiac Surgical Patients
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Date
2020-12
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Publisher
The Ohio State University
Abstract
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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Keywords
Opioids in cardiac surgery, reducing opioid use after surgery, inpatient opioid stewardship, ERAS in cardiac surgery, Multimodal pain medication