A Pain Control Optimization Pathway to Reduce Acute Postoperative Pain and Opioid Consumption Postoperatively: An Approach to Battling the Opioid Epidemic

Abstract

Practice Problem: Healthcare providers worldwide are working to battle the opioid epidemic and reduce opioid-related harm to patients. Utilizing evidence-based acute pain management methods to reduce opioid consumption is critical to combat the problem. PICOT: The PICOT question that guided this project was: In opioid-naïve adult patients undergoing general anesthesia for out-patient, minimally invasive abdominal wall hernia surgery, how does the implementation of an evidence-based, preventative Pain Control Optimization Pathway (POP) using a multimodal, opioid-sparing acute pain management technique and standardized procedure-specific opioid prescribing, compared to standard treatment, affect postoperative pain scores and opioid consumption, upon discharge from the recovery room and 72 hours postoperative? Evidence: Evidence supported utilizing a multimodal, opioid-sparing acute pain management technique, patient counseling, and opioid prescribing guidelines to improve outcomes among opioid-naïve patients undergoing abdominal surgeries. Intervention: In this pre- and post-intervention evaluation, N = 28 patients received the POP care process during the perioperative period. Outcome: Results showed the mean pain score at discharge from the recovery room decreased from 4.8 to 2.82 on the 10-point Numeric Rating Scale post-intervention (p< 0.001). Also, provider compliance with prescribing a procedure-specific opioid prescription increased from 73% to 100%, thus reducing opioid exposure and access. Conclusion: This project provided evidence that utilization of the innovative POP care process provided optimal pain control and decreased opioid consumption, consequently reducing the risk of new persistent opioid use.