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MP02-05 NEXT STOP ON THE ERAS TOUR: REDUCING POST OPERATIVE PAIN AND OPIOID USAGE THROUGH AN ENHANCED RECOVERY PATHWAY FOR PERCUTANEOUS NEPHROLITHOTOMY

2024; Lippincott Williams & Wilkins; Volume: 211; Issue: 5S Linguagem: Inglês

10.1097/01.ju.0001008600.97797.3b.05

1527-3792

Aaron Saxton, David Song, Christopher Wanderling, Austin Lee, Timothy Campbell, Stephen Hassig, Sarah Jaffe, Kaitlyn Mitchell, Rajat Jain, Scott Quarrier,

Enhanced Recovery After Surgery

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety I (MP02)1 May 2024MP02-05 NEXT STOP ON THE ERAS TOUR: REDUCING POST OPERATIVE PAIN AND OPIOID USAGE THROUGH AN ENHANCED RECOVERY PATHWAY FOR PERCUTANEOUS NEPHROLITHOTOMY Aaron Saxton, David Song, Christopher Wanderling, Austin Lee, Timothy Campbell, Stephen Hassig, Sarah Jaffe, Kaitlyn Mitchell, Rajat Jain, and Scott O. Quarrier Aaron SaxtonAaron Saxton , David SongDavid Song , Christopher WanderlingChristopher Wanderling , Austin LeeAustin Lee , Timothy CampbellTimothy Campbell , Stephen HassigStephen Hassig , Sarah JaffeSarah Jaffe , Kaitlyn MitchellKaitlyn Mitchell , Rajat JainRajat Jain , and Scott O. QuarrierScott O. Quarrier View All Author Informationhttps://doi.org/10.1097/01.JU.0001008600.97797.3b.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Optimizing analgesia after a percutaneous nephrolithotomy (PCNL) is not standardized. At our institution we instated an enhanced recovery after surgery (ERAS) pathway including a pre-op erector spinae plane (ESP) block to improve pain control post-op and minimize opioid consumption. METHODS: At our institution, an ERAS pathway was created for patients undergoing PCNL. This pathway involved a pre-op ESP block and the replacement of opioids with multi-modal analgesia post-op. Patient charts were retrospectively reviewed and placed into two cohorts – one cohort participated in the ERAS pathway while the other received traditional pain control. Opioids were available for patients in the ERAS group if their pain was not controlled. Patients were excluded if they were currently on opioid analgesics, unable to receive a pre-op block, or there was a significant non-ESP intra-op complication requiring further surgical intervention. Data collected included baseline demographics, post-op morphine equivalents (MEs) received, nursing pain scores, if an opioid was prescribed for home, and the need for any refills. Descriptive statistics were performed by unpaired student's t-test and Chi-squared test for continuous and categorical variables, respectively. RESULTS: 60 patients were identified in the ERAS cohort versus 70 in the traditional pain control cohort. Baseline demographics and results are stated in Table 1. There was a statistically significant difference in average post-op nursing pain scores between the ERAS and traditional cohorts (2.4 vs 3.6, p<0.01), as well as a significant difference in average post-op MEs received (17.0 vs 39.9, p<0.01). 46% (32/60) of patients in the ERAS cohort received an opioid prescription for home compared to 80% (56/70) in the traditional cohort (p<0.01). There was no significant difference in length of hospital stay between the ERAS and traditional cohorts (1.4 vs 1.2, p=0.45). No adverse patient events resulted from the block. CONCLUSIONS: An ERAS pathway including a preoperative ESP block and multi-modal analgesia reduced nursing pain scores post-op and decreased MEs received and opioid prescriptions for home. Future randomized prospective studies with the ERAS protocol can be considered. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e14 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Aaron Saxton More articles by this author David Song More articles by this author Christopher Wanderling More articles by this author Austin Lee More articles by this author Timothy Campbell More articles by this author Stephen Hassig More articles by this author Sarah Jaffe More articles by this author Kaitlyn Mitchell More articles by this author Rajat Jain More articles by this author Scott O. Quarrier More articles by this author Expand All Advertisement PDF downloadLoading ...