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Sleeve Gastrectomy in Mice using Surgical Clips
Published on: November 14, 2020
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Enhanced Recovery Protocol for Laparoscopic Sleeve Gastrectomy: Are Narcotics Necessary?
Richard S Hoehn1, Aaron P Seitz2, Kathleen E Singer2
1Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0558, Cincinnati, OH, 45267, USA. Richard.Hoehn@uc.edu.
Summary
Enhanced recovery after surgery (ERAS) protocols significantly reduced narcotic use in laparoscopic sleeve gastrectomy patients. This approach shows promise for minimizing opioid reliance in bariatric surgery.
Area of Science:
- Bariatric Surgery
- Surgical Protocols
- Pain Management
Background:
- Enhanced Recovery After Surgery (ERAS) protocols improve patient outcomes.
- The opioid epidemic necessitates strategies to reduce narcotic use.
- Laparatic sleeve gastrectomy is a common bariatric procedure.
Purpose of the Study:
- To evaluate the impact of an ERAS protocol on postoperative narcotic usage.
- To assess changes in length of stay, complications, and readmissions.
- To determine the feasibility of reducing narcotic dependence after bariatric surgery.
Main Methods:
- Retrospective chart review of patients undergoing laparoscopic sleeve gastrectomy.
- Comparison of narcotic usage 6 months before and after ERAS protocol implementation.
- Analysis of intravenous and oral narcotic use, complications, and readmissions.
Main Results:
- ERAS implementation led to a significant reduction in intravenous (100% to 47%) and oral schedule 2 narcotic use (56% to 6%).
- Tramadol usage increased (0% to 36%) post-ERAS.
- 52% of patients were managed without schedule 2 narcotics, and 33% received no narcotics at all post-ERAS.
Conclusions:
- ERAS protocols dramatically reduce postoperative narcotic use in laparoscopic sleeve gastrectomy.
- This strategy offers a pathway to minimize opioid requirements in bariatric surgery.
- Potential for narcotic elimination in select patients and procedures.
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