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EP022 Acute pain service utilization in an orthopedic specialty hospital
  1. Faye Rim1,2,
  2. Mary Kelly1,
  3. William Chan1,
  4. Samuel Schuessler1,
  5. Martin Plourde3,
  6. POPSSteering Committee1,
  7. Spencer Liu1,2 and
  8. Alexandra Sideris1, 2, 4
  1. 1Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA
  2. 2Department of Anesthesiology, Weill Cornell Medicine, New York, USA
  3. 3HSS Enterprise Analytics, Hospital for Special Surgery, New York, USA
  4. 4HSS Research Institute, Hospital for Special Surgery, New York, USA


Background and Aims The Perioperative Pain Service (POPS) at Hospital for Special Surgery (HSS) is a multidisciplinary team that manages acute and complex pain in orthopedic surgical patients. The team is dichotomized into an acute pain service (APS) and chronic/complex pain service (CPS). APS is consulted during hospitalization for patient-controlled analgesia (PCA) when a patient experiences uncontrolled postsurgical pain without any previously known risk factors, or when surgeons pre-emptively request this pain management strategy. The aim of this study was to identify APS utilization and case characteristics in a single, high-volume orthopedic specialty hospital.

Methods After IRB approval for a prospective, standard of care POPS registry, cases requiring an APS consult during hospitalization for orthopedic surgical procedures between January 2022 and May 2023 were identified, and metrics extracted.

Results figure 1). PCA was administered to 98% of cases, 71% of which were intravenous

(IV) opioid only and 26% were epidural PCAs. Most spine (99%) and arthroplasty (54%) cases received IV opioid only PCA. Perineural catheters were utilized in 43 (<1%) of cases, 30 (69%) of which were for upper extremity surgeries. Overall, 3% of APS cases required inpatient CPS involvement.

Abstract EP022 Figure 1

APS patient and case characteristics

Conclusions APS was the most frequently used pain consult, and most patients successfully received a PCA. A small subset of APS cases required CPS involvement, suggesting that some pain management issues required escalation.

  • acute pain service
  • patient-controlled analgesia
  • pain management

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