Sophia A. Horattas, M.D., from Cleveland Clinic Akron General, and colleagues conducted a prospective examination of all patients who underwent elective colon resections with anastomosis after Enhanced Recovery After Surgery (ERAS) implementation, which emphasized a multimodal analgesic approach, including patient education. Data were included for 155 patients during 2016 to 2018.
The researchers found that 83 percent of the patients required no narcotic medication postoperatively. Preoperative opioid use significantly predicted postoperative narcotic requirement, with 56 percent of 15 patients requiring postoperative narcotic analgesics. Eighty-five percent of the 140 patients without preoperative opioid exposure did not require postoperative narcotics. The average length of stay was 2.7 days for patients receiving narcotics versus 2.3 days for the non-narcotic group. Across the study duration, there was an increase in protocol compliance, which was associated with a 20 percent increase in narcotic avoidance during the study period.
“Over 75 percent of our elective colorectal patients underwent surgery without requiring narcotic analgesics postoperatively, including after discharge,” Horattas said in a statement. “During this time period our patient satisfaction scores improved as well as patients’ perceptions of pain control.”