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Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice

Despite dominating fewer headlines, the opioid epidemic continues to plague society. Surgeons have the responsibility to change their opioid prescribing habits while maintaining adequate patient comfort. This study examines the transition to a multimodal, perioperative protocol in an ambulatory surg...

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Detalles Bibliográficos
Autores principales: Price, Melissa S., Fryer, Richard H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870214/
https://www.ncbi.nlm.nih.gov/pubmed/36699223
http://dx.doi.org/10.1097/GOX.0000000000004777
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author Price, Melissa S.
Fryer, Richard H.
author_facet Price, Melissa S.
Fryer, Richard H.
author_sort Price, Melissa S.
collection PubMed
description Despite dominating fewer headlines, the opioid epidemic continues to plague society. Surgeons have the responsibility to change their opioid prescribing habits while maintaining adequate patient comfort. This study examines the transition to a multimodal, perioperative protocol in an ambulatory surgery setting for abdominoplasty patients. We hypothesized that using multimodal analgesia could significantly reduce narcotic consumption. METHODS: The authors retrospectively compared one surgeon’s consecutive abdominoplasty patients over 24 months. The control group received primarily narcotic medications to manage pain, and the treatment cohort was given a multimodal protocol for perioperative analgesia. RESULTS: Demographic data, surgical time, and postanesthesia care unit time between the groups were similar. Although the mean intravenous narcotic decreased in the operating room and postanesthesia care unit for the treatment group, it failed to achieve statistical significance. The treatment cohort was prescribed two-thirds less oral narcotic than the control (251 versus 787 mean morphine milligram equivalents P < 0.001). Ten patients in the treatment cohort used no oral narcotics compared to one in the control (P = 0.002), and only four narcotic refills were given in the treatment group compared to 36 in the control (P < 0.001), suggesting that the treatment group had better pain control despite taking fewer narcotics. CONCLUSIONS: Optimally utilizing multimodal medications effectively reduces narcotic consumption while effectively managing postoperative pain from abdominoplasty in a private practice, ambulatory surgery setting. Surgeons must change their prescribing habits if we are going to make progress in the war against the opioid crisis.
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spelling pubmed-98702142023-01-24 Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice Price, Melissa S. Fryer, Richard H. Plast Reconstr Surg Glob Open Cosmetic Despite dominating fewer headlines, the opioid epidemic continues to plague society. Surgeons have the responsibility to change their opioid prescribing habits while maintaining adequate patient comfort. This study examines the transition to a multimodal, perioperative protocol in an ambulatory surgery setting for abdominoplasty patients. We hypothesized that using multimodal analgesia could significantly reduce narcotic consumption. METHODS: The authors retrospectively compared one surgeon’s consecutive abdominoplasty patients over 24 months. The control group received primarily narcotic medications to manage pain, and the treatment cohort was given a multimodal protocol for perioperative analgesia. RESULTS: Demographic data, surgical time, and postanesthesia care unit time between the groups were similar. Although the mean intravenous narcotic decreased in the operating room and postanesthesia care unit for the treatment group, it failed to achieve statistical significance. The treatment cohort was prescribed two-thirds less oral narcotic than the control (251 versus 787 mean morphine milligram equivalents P < 0.001). Ten patients in the treatment cohort used no oral narcotics compared to one in the control (P = 0.002), and only four narcotic refills were given in the treatment group compared to 36 in the control (P < 0.001), suggesting that the treatment group had better pain control despite taking fewer narcotics. CONCLUSIONS: Optimally utilizing multimodal medications effectively reduces narcotic consumption while effectively managing postoperative pain from abdominoplasty in a private practice, ambulatory surgery setting. Surgeons must change their prescribing habits if we are going to make progress in the war against the opioid crisis. Lippincott Williams & Wilkins 2023-01-23 /pmc/articles/PMC9870214/ /pubmed/36699223 http://dx.doi.org/10.1097/GOX.0000000000004777 Text en Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Cosmetic
Price, Melissa S.
Fryer, Richard H.
Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice
title Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice
title_full Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice
title_fullStr Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice
title_full_unstemmed Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice
title_short Multimodal Pain Control Reduces Narcotic Use after Outpatient Abdominoplasty: Retrospective Analysis in an Ambulatory Surgery Practice
title_sort multimodal pain control reduces narcotic use after outpatient abdominoplasty: retrospective analysis in an ambulatory surgery practice
topic Cosmetic
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9870214/
https://www.ncbi.nlm.nih.gov/pubmed/36699223
http://dx.doi.org/10.1097/GOX.0000000000004777
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