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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Stages of General Anesthesia01:22

Stages of General Anesthesia

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Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Standardization of Narcotic Prescriptions in Minimally Invasive General Surgery Procedures.

Astrid Leon1, Justin Robbins1, Ashley Hughes1

  • 1Department of Surgery, Boonshoft School of Medicine, Wright State University, Dayton, Ohio.

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Implementing standardized postoperative opioid protocols reduced narcotic prescriptions without compromising pain control. This approach effectively addresses the opioid crisis by optimizing pain management after common surgical procedures.

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Area of Science:

  • Surgical Outcomes
  • Pain Management
  • Public Health

Background:

  • The opioid crisis remains a significant public health concern, with postoperative opioid use contributing to the problem.
  • Standardized protocols are increasingly adopted to mitigate excess opioid availability in healthcare settings.

Purpose of the Study:

  • To establish and evaluate a standardized pain management protocol for common surgical procedures.
  • To assess the impact of this protocol on postoperative pain control and opioid utilization.

Main Methods:

  • A prospective observational study adhering to the Michigan Opioid Prescribing Engagement Network guidelines.
  • Evaluation of laparoscopic/robotic cholecystectomy, appendectomy, and herniorrhaphy patients.
  • Utilized a multimodal pain regimen with predetermined narcotic prescriptions and postoperative surveys.

Main Results:

  • Fewer patients on the protocol required opioid refills (9.6% vs. 18.1%, P=0.007).
  • Protocol patients took significantly fewer narcotics (median 5.0 vs. 10.0, P<0.001).
  • No significant difference in pain control was observed between protocol and non-protocol groups (91.1% vs. 90.5%, P=1.0).

Conclusions:

  • Standardized postoperative opioid prescribing protocols can effectively decrease opioid prescriptions.
  • Implementing such protocols, combined with multimodal pain management, ensures adequate pain control post-surgery.
  • This strategy offers a viable solution for reducing opioid use in surgical settings.