Cleveland Clinic Akron (Ohio) General Hospital surgeons created a treatment protocol that sends patients home after colorectal operations without any opioids, which led to shorter hospital stays, researchers reported at the American College of Surgeons clinical congress.
"Over 75 percent of our elective colorectal patients underwent surgery without requiring narcotic analgesics postoperatively, including after discharge," said lead study author Sophia Horattas, MD. "During this time period our patient satisfaction scores improved as well as patients' perceptions of pain control."
The protocol is called enhanced recovery after surgery, or ERAS. It includes patient education on pain management, pre-emptive pain management, use of a nonopioid general anesthesia during operations and non-narcotic analgesics after surgery.
All eight general surgeons at Cleveland Clinic Akron General adopted the protocol in 2016. The study authors looked at outcomes of 155 patients who had elective colon operations with resection after the ERAS protocol.
Patients on narcotic pain management after operations typically spent more time in the hospital — an average of 2.7 days versus 2.3 days for the non-narcotic group, the researchers found.
A key part of the ERAS protocol is having a patient education discussion before the operation, which involves patients meeting with the surgeon and nursing care coordinator, according to Dr. Horattas.
"Patient education played a large role in protocol compliance, and patient satisfaction improved as they were able to avoid prolonged fasting, achieve improved pain control without the side effects of narcotic analgesia, and be discharged home earlier," Dr. Horattas said.
More articles on clinical leadership and infection control:
Businesses are using 'smart thermometer' data to target ads to patients
7th death reported in NJ adenovirus outbreak
Antipsychotics used in hospital patients don't treat delirium, study finds