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Open Access

Opioid stewardship after emergency laparoscopic general surgery

Celina Nahanni, Ashlie Nadler, Avery B Nathens
DOI: 10.1136/tsaco-2019-000328 Published 23 September 2019
Celina Nahanni
1Department of Surgery, University of Toronto, Toronto, Ontario, Canada
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Ashlie Nadler
2Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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Avery B Nathens
2Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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    Figure 1

    Consolidated Standards of Reporting Trials (CONSORT) flow diagram. Eligible charts were randomized and screened until the target of n=100 for each of the two groups was met.

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    Figure 2

    In-hospital compared with discharge (D/C) prescription opioids in oral morphine equivalents (OME) by opioid and non-opioid compared with opioid-only pain management strategies. *Statistically significant with p<0.05. +No correlation.

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    Figure 4

    In-hospital compared with discharge prescription opioids in oral morphine equivalents (OME) per day.

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    Figure 3

    Average numerical pain scores out of 10 recorded within 12 hours prior to discharge. *Statistically significant with p<0.05.

Tables

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  • Table 1

    Postoperative analgesia requirements of emergency general surgery patients in hospital

    Appendectomies (%)Cholecystectomies (%)All (%)
    No analgesia172219.5
    Non-opioids only15811.5
    Opioids+non-opioids534951
    Opioids only152118
  • Table 2

    Average time to first dose of analgesia in hospital for opioid and non-opioid analgesia

    Time to first dose (hours)P value
    All opioid analgesia4.97 (0.42)
    All non-opioid analgesia6.91 (0.49)0.003*
    Combination opioidsOpioid4.80 (0.47)
    Non-opioid7.08 (0.58)0.003*
    Separate opioidsOpioid only5.46 (0.90)
    Non-opioid only6.16 (0.70)0.55
    • *Statistically significant with p<0.05.

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Opioid stewardship after emergency laparoscopic general surgery
Celina Nahanni, Ashlie Nadler, Avery B Nathens
Trauma Surg Acute Care Open Sep 2019, 4 (1) e000328; DOI: 10.1136/tsaco-2019-000328

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Opioid stewardship after emergency laparoscopic general surgery
Celina Nahanni, Ashlie Nadler, Avery B Nathens
Trauma Surg Acute Care Open Sep 2019, 4 (1) e000328; DOI: 10.1136/tsaco-2019-000328
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Opioid stewardship after emergency laparoscopic general surgery
Celina Nahanni, Ashlie Nadler, Avery B Nathens
Trauma Surgery & Acute Care Open Sep 2019, 4 (1) e000328; DOI: 10.1136/tsaco-2019-000328
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