Enhanced recovery protocol for transoral robotic surgery demonstrates improved analgesia and narcotic use reduction.


Journal

American journal of otolaryngology
ISSN: 1532-818X
Titre abrégé: Am J Otolaryngol
Pays: United States
ID NLM: 8000029

Informations de publication

Date de publication:
Historique:
received: 24 06 2020
accepted: 30 06 2020
pubmed: 28 7 2020
medline: 15 12 2020
entrez: 28 7 2020
Statut: ppublish

Résumé

No study has evaluated the impact of the Enhanced Recovery After Surgery (ERAS) protocol on opioid usage among patients undergoing transoral robotic surgery (TORS). In this retrospective study, patients undergoing TORS were enrolled in an ERAS protocol and compared to control patients. Primary outcome measures included postoperative mean morphine equivalent dose (MED), Defense and Veterans Pain Rating Scale (DVPRS) pain scores, and opioid prescriptions on discharge. The mean MED administered postoperatively was lower in the ERAS group (17.6 mg) than in the control group (65.0 mg) (p < .001). Average postoperative DVPRS scores were 2.9 in the ERAS group vs. 4.2 in the control group (p = .042). Fewer patients in the ERAS group received opioid prescriptions on discharge (31.6%) than controls (96.2%) (p < .001). The TORS ERAS protocol is associated with reduced postoperative opioid usage, lower pain scores, and reduced opioid requirements on discharge.

Sections du résumé

BACKGROUND BACKGROUND
No study has evaluated the impact of the Enhanced Recovery After Surgery (ERAS) protocol on opioid usage among patients undergoing transoral robotic surgery (TORS).
METHODS METHODS
In this retrospective study, patients undergoing TORS were enrolled in an ERAS protocol and compared to control patients. Primary outcome measures included postoperative mean morphine equivalent dose (MED), Defense and Veterans Pain Rating Scale (DVPRS) pain scores, and opioid prescriptions on discharge.
RESULTS RESULTS
The mean MED administered postoperatively was lower in the ERAS group (17.6 mg) than in the control group (65.0 mg) (p < .001). Average postoperative DVPRS scores were 2.9 in the ERAS group vs. 4.2 in the control group (p = .042). Fewer patients in the ERAS group received opioid prescriptions on discharge (31.6%) than controls (96.2%) (p < .001).
CONCLUSION CONCLUSIONS
The TORS ERAS protocol is associated with reduced postoperative opioid usage, lower pain scores, and reduced opioid requirements on discharge.

Identifiants

pubmed: 32717682
pii: S0196-0709(20)30343-4
doi: 10.1016/j.amjoto.2020.102649
pii:
doi:

Substances chimiques

Narcotics 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102649

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Ashwin Ganti (A)

Rush Medical College, Rush University Medical Center, Chicago, IL, United States of America.

Michael Eggerstedt (M)

Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America.

Kevin Grudzinski (K)

Rush Medical College, Rush University Medical Center, Chicago, IL, United States of America.

Emily A Ramirez (EA)

Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America.

Deborah Vaughan (D)

Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America.

Peter C Revenaugh (PC)

Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America.

Kerstin Stenson (K)

Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America.

Samer Al-Khudari (S)

Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America. Electronic address: Samer_Al-Khudari@rush.edu.

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Classifications MeSH