ERAS Protocol Can Cut Opioid Use After Spine Surgery
Decline seen in postoperative opioid requirements after elective spinal, peripheral nerve surgery
WEDNESDAY, Feb. 6, 2019 (Pharmacist's Briefing) -- Implementation of a novel enhanced recovery after surgery (ERAS) protocol can reduce patients' postoperative opioid requirements after elective spinal or peripheral nerve surgery, according to a study recently published in the Journal of Neurosurgery.
Zarina S. Ali, M.D., from the University of Pennsylvania in Philadelphia, and colleagues compared the clinical outcomes of patients undergoing elective spine or peripheral nerve surgery after implementation of the ERAS protocol (201 patients) with a historical control cohort who received traditional perioperative care (74 patients).
The researchers found that in the ERAS group, intravenous opioid medications administered postoperatively via patient-controlled analgesia were nearly eliminated (0.5 versus 54.1 percent). There was no increase in average or daily pain scores in the ERAS group in association with this change. A smaller proportion of patients in the ERAS group were using opioids at one month after surgery (38.8 versus 52.7 percent). Compared with the control group, the ERAS group had greater mobilization on postoperative day 0 (53.4 versus 17.1 percent) and postoperative day 1 (84.1 versus 45.7 percent). The ERAS group had a decrease in postoperative Foley use (20.4 versus 47.3 percent).
"ERAS protocols engage each aspect of the patient's surgical journey to improve clinical outcomes and optimize a safe recovery," Ali said in a statement. "This novel approach allows a framework for addressing pain management in a responsible and effective manner while dramatically reducing opioid use."