Evaluation of a multidisciplinary, multimodal pain management protocol following pancreas transplantation

Abstract

Introduction: Patients undergoing solid-organ transplantation demonstrate pain arising from both the surgical intervention and pre-existing comorbidities. High levels of opioid use both pre-and post-transplant are associated with unfavorable transplant outcomes. Patient education, multimodal therapy, and discharge planning have all been demonstrated to reduce opioid use after transplant.Methods: This is a single-center, retrospective study analyzing patients before and after implementation of a multimodal, multidisciplinary pain management protocol.Morphine milligram equivalents (MMEs) use during the index transplant hospitalization and the need for opioids at discharge was compared between the pre-and post-protocol groups.Results: A total of 52 patients were included in the study, 31 in the pre and 21 in the post-protocol groups. Inpatient MME use was reduced from 135.5 to 67.5 MMEs after protocol implementation. Additionally, the number of patients discharged on opioids following transplant decreased from 90.3% to 47.6%. Pain scores, length of stay (LOS), and return of bowel function was not different between groups. Conclusion:The implementation of a multimodal, multidisciplinary pain management protocol significantly decreased opioid use during the post-surgical hospitalization and in the 6 months following transplantation. A combination of non-opioid analgesics, patient education, and discharge planning can be beneficial elements in pancreas transplant pain management.

Abdominal Organ Transplantation: Noteworthy Literature in 2023

“…Lindner et al studied the effects of implementing a multimodal, multidisciplinary pain management protocol in patients undergoing pancreas transplantation. 43 This single-center, retrospective study included 52 patients: 31 in the pre-protocol group and 21 in the post-protocol group. The protocol involved a combination of patient education, non-opioid analgesics, and patient-centered discharge planning.…”