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Enhanced Oil Recovery using a Combination of Biosurfactants
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Enhanced Oil Recovery using a Combination of Biosurfactants

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Decreased opioid prescribing in children using an enhanced recovery protocol

Katherine J Baxter1, Heather L Short1, Martha Wetzel2

  • 1Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA.

Journal of Pediatric Surgery
|March 20, 2019
PubMed

Insights

Implementing an Enhanced Recovery Protocol (ERP) for pediatric gastrointestinal surgery significantly reduced post-discharge opioid prescriptions. This protocol also lowered length of stay and in-hospital opioid use in young patients.

Area of Science:

  • Pediatric Surgery
  • Pain Management
  • Enhanced Recovery Protocols

Background:

  • Previous implementation of an Enhanced Recovery Protocol (ERP) for pediatric elective gastrointestinal operations showed reduced length of stay (LOS) and in-hospital opioid use.
  • The study hypothesized that the ERP would also decrease postdischarge opioid prescribing.

Purpose of the Study:

  • To evaluate the impact of an Enhanced Recovery Protocol (ERP) on postdischarge opioid prescribing in pediatric patients undergoing elective gastrointestinal surgery.

Main Methods:

  • A retrospective cohort study compared demographic, operative, and opioid prescription data.
  • Data were analyzed from elective gastrointestinal surgical patients before the ERP (January 2012–December 2014) and after the ERP (January 2015–December 2017).

Main Results:

  • Patients receiving an opioid prescription at discharge decreased from 69.8% pre-ERP to 30.9% post-ERP (p < 0.01).
  • Intraoperative and postoperative opioid use also significantly decreased in the post-ERP period.
  • Length of stay reduced from a median of 4 days to 3 days (p = 0.02).

Conclusions:

  • The pediatric gastrointestinal surgery Enhanced Recovery Protocol (ERP) was associated with a significant reduction in postdischarge opioid prescribing.
  • The findings support the broader benefits of ERP in pediatric surgical care, extending beyond in-hospital outcomes.
Abstract

Keywords:
Enhanced recoveryNarcoticsOpioidsPediatric surgeryStewardship

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