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- W4251914762 abstract "Thank you, Dr. Mark Kendall for your comments and questions. To answer your first question concerning the standardization of intraoperative opioid analgesics, all patients received spinal anesthetics with bupivacaine, yet no opioid, such as Duramorph. A standardized periarticular injection consisting of ropivacaine 200 mg and morphine sulfate 5 mg was used rather than a femoral nerve block. Ketorolac 30 mg was also included if the glomerular filtration rate and creatinine were within normal limits. Any additional intraoperative opioid use was at the discretion of the anesthesia provider including intravenous fentanyl and hydromorphone, as this allowed for treatment variations according to patient analgesic requirements. Table 1 displays the use of intravenous opioids that were not standardized. Although these medications were not standardized, use was cumulatively less in the postimplementation group. The postimplementation group was identified by anesthesia providers to require less intraoperative opioids. Table 1Nonstandardized Intraoperative Analgesic Use Before and After Implementation of the Standardized Multimodal Analgesia Regimen Preimplementation Postimplementation Number of Patients Who Received Medication (Medication Dose Range; mg) Fentanyl IV 24 (0.05-0.5) 13 (0.5-0.25) Hydromorphone IV 17 (1-2) 6 (1-2) Duramorph intrathecal 5 (0.25-0.3) 0 IV, intravenous. Open table in a new tab IV, intravenous. Multimodal Perioperative Analgesia Regimen: All Clear?Journal of PeriAnesthesia NursingVol. 33Issue 5PreviewI read with great interest the article by Donahue et al1 in a recent issue of the Journal of PeriAnesthesia Nursing. The authors performed an implementation study on patients undergoing total knee arthroplasty and concluded that implementing a standardized evidence-based multimodal analgesia regimen and patient-educational video resulted in improved mobilization, reduced opioid consumption, and reduced length of stay. The authors should be congratulated for performing a well-designed study on an important topic (eg, acute pain) in patients undergoing surgical procedures. Full-Text PDF" @default.
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- W4251914762 date "2018-10-01" @default.
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- W4251914762 doi "https://doi.org/10.1016/j.jopan.2018.07.005" @default.
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