Adrian Maghiar, George Dejeu, Mihai Botea, Dan Ciurtin, Marius Sfirlea, Octavian Maghiar, Cipri Puscas. Spitalul Pelican Oradea
We present the preliminary findings of a study we started in our institution, Pelican Hospital in Oradea, Romania. In the past 12 months we started a study to quantify the reduction of opioid pain medication need reduction in patients with major abdominal surgery that get wound margins infiltration of local anesthesia during closure.
During this period we measured the pain score as decided by the patients (using a 10 degrees pain score meter) at 1 hour, 3 hours, 6 hours, 12 hours and 24 hours after surgery. We divided the patients in 3 groups. First group, the control, we used our usual protocol of pain management using opioids, the second group we used a revised protocol using paracetamol and metamizole, and the third group we used our revised protocol and the infiltration of the surgical wounds at the time of closure with local anesthesia.
The results show a clear reduction in pain score at 1, 3 and 6 hours after surgery for the group using the local anesthesia, with a statistical significance. The difference between the standard and revised protocols of pain management (with no local anesthesia) was not statistically significant, with a very slight advantage for the opioid group. However the results at 12 and 24 hours were more interesting, with pain scores much lower for the local anesthesia group, and also the revised protocol group, with a overall reduction in the need for opioid treatment of more than 80% when compared with a similar group from 12 months before the study begun. We continue to research the implications of the use of the revised protocol, that now includes the infiltration of surgery wounds with local anesthesia at the time of closure. And are looking at the economic impact on the surgery ward budget the reduction in opioid use brings. One interesting finding is the reduction in hospital stay for patients with less than 2 doses of opioid needed for pain control, of as much as 3 days on average, an effect that we are currently studying more closely with a different study.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95939
Program Number: P631
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster