Opioid rescue analgesia in post-anesthesia care unit
(PACU-OpResc) can be used as a quality assurance approach for the improvement
of analgesia.
PACU-OpResc can be used as a quality assurance approach or substitute for the efficacy of epidural analgesia used after thoracic and abdominal surgery (TEA), a study published in BMC Anesthesiology deduced. This can be especially beneficial to track the performance and observe the innovation efforts intended for the improvement of analgesia.
To investigate the usefulness of PACU-OpResc, Nadav Levy et al. performed a retrospective analysis of all TEA placements over 3 years. PACU length of stay was the primary outcome. Causes for delayed PACU discharge and intraoperative hypotension were the secondary outcomes. The positive predictive value (PPV) of PACU-OpResc for insufficient TEA was determined as per the post-analysis chart review.
Two hundred and eleven (22.1%) patients needed PACU-OpResc who received
preoperative TEA, was linked with longer PACU length of stay and postponed
discharge due to ineffective pain relief. The PPV of PACU-OpResc for
reevaluation was 76.3 and for manipulation, it was 60.4% of TEA catheter in
PACU. The mean compliance with the documented sensory level check following the
placement of TEA per month was observed to be 39.7% after the execution of a
checkbox. At the same time, a decrease of 8.2% in the PACU-OpResc rate was
detected.
BMC Anesthesiology
Evaluation of early postoperative intravenous opioid rescue as a novel quality measure in patients who receive thoracic epidural analgesia: a retrospective cohort analysis and prospective performance improvement intervention
Nadav Levy et al.
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