PT  - JOURNAL ARTICLE
AU  - Votta-Velis, Gina
AU  - Daviglus, Martha L
AU  - Borgeat, Alain
AU  - Beckmann, Katharina
AU  - Ta, Andrew Q
AU  - Parker, John L
AU  - Kravets, Sasha
AU  - Garcia, Olga L
AU  - Pirzada, Amber
AU  - Gastala, Nicole
AU  - Valle, Valentina
AU  - Benken, Jamie J
AU  - Campara, Maya
AU  - Aguiluz, Gabriela
AU  - Memtsoudis, Stavros G
AU  - Giulianotti, Pier C
AU  - Benedetti, Enrico
TI  - Surgical opioid-avoidance protocol: a postoperative pharmacological multimodal analgesic intervention in diverse patient populations
AID  - 10.1136/rapm-2022-103864
DP  - 2023 Dec 01
TA  - Regional Anesthesia & Pain Medicine
PG  - 594--600
VI  - 48
IP  - 12
4099  - http://rapm.bmj.com/content/48/12/594.short
4100  - http://rapm.bmj.com/content/48/12/594.full
SO  - Reg Anesth Pain Med2023 Dec 01; 48
AB  - Introduction This study evaluated the effect of a surgical opioid-avoidance protocol (SOAP) on postoperative pain scores. The primary goal was to demonstrate that the SOAP was as effective as the pre-existing non-SOAP (without opioid restriction) protocol by measuring postoperative pain in a diverse, opioid-naive patient population undergoing inpatient surgery across multiple surgical services.Methods This prospective cohort study was divided into SOAP and non-SOAP groups based on surgery date. The non-SOAP group had no opioid restrictions (n=382), while the SOAP group (n=449) used a rigorous, opioid-avoidance order set with patient and staff education regarding multimodal analgesia. A non-inferiority analysis assessed the SOAP impact on postoperative pain scores.Results Postoperative pain scores in the SOAP group compared with the non-SOAP group were non-inferior (95% CI: −0.58, 0.10; non-inferiority margin=−1). The SOAP group consumed fewer postoperative opioids (median=0.67 (IQR=15) vs 8.17 morphine milliequivalents (MMEs) (IQR=40.33); p<0.01) and had fewer discharge prescription opioids (median=0 (IQR=60) vs 86.4 MMEs (IQR=140.4); p<0.01).Discussion The SOAP was as effective as the non-SOAP group in postoperative pain scores across a diverse patient population and associated with lower postoperative opioid consumption and discharge prescription opioids.Data are available upon reasonable request.