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John L. Dart Library
9 a.m. – 7 p.m.
Phone: (843) 722-7550
West Ashley Library
9 a.m. – 7 p.m.
Phone: (843) 766-6635
Folly Beach Library
Closed
Phone: (843) 588-2001
Edgar Allan Poe/Sullivan's Island Library
Closed for renovations
Phone: (843) 883-3914
Wando Mount Pleasant Library
9 a.m. – 8 p.m.
Phone: (843) 805-6888
Village Library
9 a.m. – 6 p.m.
Phone: (843) 884-9741
St. Paul's/Hollywood Library
9 a.m. – 8 p.m.
Phone: (843) 889-3300
Otranto Road Library
9 a.m. – 8 p.m.
Phone: (843) 572-4094
Mt. Pleasant Library
9 a.m. – 8 p.m.
Phone: (843) 849-6161
McClellanville Library
9 a.m. - 6 p.m.
Phone: (843) 887-3699
Keith Summey North Charleston Library
9 a.m. – 8 p.m.
Phone: (843) 744-2489
John's Island Library
9 a.m. – 8 p.m.
Phone: (843) 559-1945
Hurd/St. Andrews Library
9 a.m. – 8 p.m.
Phone: (843) 766-2546
Miss Jane's Building (Edisto Library Temporary Location)
9 a.m. – 6 p.m.
Phone: (843) 869-2355
Dorchester Road Library
9 a.m. – 8 p.m.
Phone: (843) 552-6466
Baxter-Patrick James Island
9 a.m. – 8 p.m.
Phone: (843) 795-6679
Main Library
9 a.m. – 8 p.m.
Phone: (843) 805-6930
Bees Ferry West Ashley Library
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Phone: (843) 805-6892
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9 a.m. - 5 p.m.
Phone: (843) 805-6909
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Reduction of Postoperative Opioid Use After Elective Spine and Peripheral Nerve Surgery Using an Enhanced Recovery After Surgery Program.
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- Author(s): Flanders, Tracy M; Ifrach, Joseph; Sinha, Saurabh; Joshi, Disha S; Ozturk, Ali K; Malhotra, Neil R; Pessoa, Rachel; Kallan, Michael J; Fleisher, Lee A; Ashburn, Michael A; Maloney, Eileen; Welch, William C; Ali, Zarina S
- Source:
Pain Medicine; Dec2020, Vol. 21 Issue 12, p3283-3291, 9p- Subject Terms:
PERIPHERAL nervous system surgery; SPINAL surgery; THERAPEUTIC use of narcotics; ANALGESICS; COMPARATIVE studies; DRUG utilization; LENGTH of stay in hospitals; LONGITUDINAL method; NEUROSURGERY; PATIENT satisfaction; PATIENTS; POSTOPERATIVE care; POSTOPERATIVE pain; POSTOPERATIVE period; SURGERY; ELECTIVE surgery; PAIN measurement; TREATMENT effectiveness; DESCRIPTIVE statistics; EARLY ambulation (Rehabilitation) - Source:
- Additional Information
- Abstract: Objective Enhanced recovery after surgery (ERAS) pathways have previously been shown to be feasible and safe in elective spinal procedures. As publications on ERAS pathways have recently emerged in elective neurosurgery, long-term outcomes are limited. We report on our 18-month experience with an ERAS pathway in elective spinal surgery. Methods A historical cohort of 149 consecutive patients was identified as the control group, and 1,141 patients were prospectively enrolled in an ERAS protocol. The primary outcome was the need for opioid use one month postoperation. Secondary outcomes were opioid and nonopioid consumption on postoperative day (POD) 1, opioid use at three and six months postoperation, inpatient pain scores, patient satisfaction scores, postoperative Foley catheter use, mobilization/ambulation on POD0–1, length of stay, complications, and intensive care unit admissions. Results There was significant reduction in use of opioids at one, three, and six months postoperation (38.6% vs 70.5%, P < 0.001, 36.5% vs 70.9%, P < 0.001, and 23.6% vs 51.9%, P = 0.008) respectively. Both groups had similar surgical procedures and demographics. PCA use was nearly eliminated in the ERAS group (1.4% vs 61.6%, P < 0.001). ERAS patients mobilized faster on POD0 compared with control (63.5% vs 20.7%, P < 0.001). Fewer patients in the ERAS group required postoperative catheterization (40.7% vs 32.7%, P < 0.001). The ERAS group also had decreased length of stay (3.4 vs 3.9 days, P = 0.020). Conclusions ERAS protocols for all elective spine and peripheral nerve procedures are both possible and effective. This standardized approach to patient care decreases opioid usage, eliminates the use of PCAs, mobilizes patients faster, and reduces length of stay. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Pain Medicine is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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