Background and Aims Thoracic surgery is often referred to as the most painful surgery. Acute pain management in the post operative phase can therefore be challenging. In line with current best practice and the ERATS guidance we updated our institutional post operative analgesic recommendations for patients undergoing thoracic surgery. We aimed to assess adherence to the updated prescribing guidance.
Methods Over a 6-month period we audited the compliance with prescribing in line with our updated recommendations. Patients electronic drug charts were reviewed retrospectively after undergoing thoracic surgery.
Results Our results demonstrated that the majority of patients were prescribed post operative analgesia in line with the institutional recommendations. 208 patients were included. 83% of these underwent VATS surgery and 17% had a thoracotomy. 84% of patients has some form of regional/neuraxial technique as part of their post operative analgesic regimen. 98.5% of patients were prescribed post operative paracetamol. 70% of patients were prescribed a NSAID. Overall compliance with the prescribing guidance was 62%.
Conclusions The effective changes to our institutional analgesic recommendations for thoracic surgery were removal of the routine use of slow release opioid and gabapentinoids. This is in keeping with the current international recommendations about using these agents in the routine management of of postoperative pain. This has the potential to improve patients post operative outcomes by reducing administration of medications that have a significant side effect profile. Our audit highlights that while the majority of patients did receive a regional technique for their surgery further work could be done to increase this further.
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