UASSIGNED:我们以前报道过,在我们机构中,>50%的术后阿片类药物未用于耳鼻喉科普通手术。基于这些发现,我们建立了多式联运,术后疼痛管理的循证指南。在我们多相研究的第二部分,我们评估了这些指南对(1)未使用阿片类药物数量的影响,(2)患者满意度,和(3)对阿片类药物流行和处方指南的机构看法。
未经评估:标准化,我们利用我们研究第一阶段的前瞻性数据和现有文献的证据,制定了特定程序的阿片类药物处方指南.再一次,我们检查了唾液内镜,腮腺切除术,甲状旁腺切除术/甲状腺切除术,和经口机器人手术(TORS)。患者在第一次术后预约时进行了调查。比较来自阶段I和II的组。在多相项目开始之前和实施处方指南之后,对主治医师进行了调查。
UNASSIGNED:处方指南导致每名患者处方吗啡毫克当量(MME)平均减少48%(唾液酸内镜检查),63%(腮腺切除术),60%(甲状腺切除术),和42%(TORS)。每位患者用于腮腺切除术的平均使用MME显着减少(64%)。实施指南后,每位患者未使用的MME比例和患者满意度评分没有显着变化。
UNASSIGNED:阿片类药物处方指南的实施和多模式镇痛的使用大大减少了所有程序中阿片类药物的处方量,而不会影响患者的满意度。
未经评估:2.
UNASSIGNED: We previously reported that >50% of postoperative opioids prescribed at our institution went unused for common otolaryngologic procedures. Based on these findings, we instituted multimodal, evidence-based
guidelines for postoperative pain management. In the second part of our multiphasic study, we evaluated the effects of these
guidelines on (1) quantity of unused opioids, (2) patient satisfaction, and (3) institutional perceptions toward the opioid epidemic and prescribing guidelines.
UNASSIGNED: Standardized, procedure-specific opioid prescription
guidelines were created using prospective data from the first phase of our study and evidence from current literature. Again, we examined
sialendoscopy, parotidectomy, parathyroidectomy/thyroidectomy, and transoral robotic surgery (TORS). Patients were surveyed at their first postoperative appointment. Groups from Phases I and II were compared. Attending physicians were surveyed before the start of the multiphasic project and after prescribing guidelines were implemented.
UNASSIGNED: Prescribing guidelines led to an average reduction in prescribed morphine milligram equivalents (MME) per patient by: 48% (
sialendoscopy), 63% (parotidectomy), 60% (para/thyroidectomy), and 42% (TORS). Average used MME per patient for parotidectomy was significantly reduced (64%). The proportion of unused MME per patient and patient satisfaction scores did not significantly change after guidelines were implemented.
UNASSIGNED: Implementation of opioid-prescribing guidelines and the use of multimodal analgesia substantially reduced the amount of opioids prescribed across all procedures without impacting patient satisfaction.
UNASSIGNED: 2.