Patients having major surgery without opioids have shorter LOS

Editor's Note

A treatment protocol that sends patients home after colorectal surgery without any opioids, resulted in shorter hospital length of stay (LOS) in this study presented October 22 at the American College of Surgeons 2018 Clinical Congress in Boston.

The Enhanced Recovery After Surgery protocol included:

• patient education about pain management before surgery
• preemptive pain management
• nonopioid general anesthesia
• modified blocks of abdominal nerves
• postoperative programmed nonnarcotic analgesics.

Of 155 patients analyzed, use of opioids before surgery was an indicator patients would need opioids to manage pain after surgery, as 9 of 15 did. Of the remaining 140 patients who did not use opioids preoperatively, 85% (119) did not require narcotics postoperatively.

Patients on narcotic pain management after surgery spent an average of 2.7 days in the hospital versus 2.3 days for the nonnarcotic group.

A key element of the protocol is a patient education discussion before surgery, which involves the patient meeting with the surgeon and nursing care coordinator, the researchers say.