Abstract
The aim of this retrospective study was to evaluate the effect of implementing the combination of thoracic epidural analgesia and multimodal analgesia by a dedicated acute pain service on opioid consumption and postoperative outcomes in patients undergoing pancreaticoduodenectomy. Opioid consumption during postoperative days 0–3 was compared in the acute pain service versus non-acute pain service cohort. Between matched cohorts, the median (quartiles) total opioid consumption during postoperative days 0–3 was 114mg morphine equivalents (54.7, 212.4mg morphine equivalents) in the non-acute pain service cohort and 47.4mg morphine equivalents (38.1, 100.8mg morphine equivalents) in the acute pain service cohort; the median difference was 44.8mg morphine equivalents (95% CI 14.2–90.2mg morphine equivalents, p = 0.002). The median difference in hospital length of stay was 2.0 days (95% confidence interval 0.8–4.0, p = 0.01), favouring the acute pain service cohort. A dedicated acute pain service implementing thoracic epidural analgesia in conjunction with multimodal analgesia was associated with decreased opioid consumption and hospital length of stay.
Original language | English (US) |
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Pages (from-to) | 309-314 |
Number of pages | 6 |
Journal | Journal of perioperative practice |
Volume | 30 |
Issue number | 10 |
DOIs | |
State | Published - Oct 1 2019 |
Externally published | Yes |
Keywords
- Acute pain service
- Analgesia
- Epidural
- Pancreaticoduodenectomy
ASJC Scopus subject areas
- Surgery
- Medical–Surgical
- Anesthesiology and Pain Medicine