HealthDay News — An enhanced recovery after surgery program complemented by a preemptive pain management program is associated with a decrease in opioid prescriptions at discharge following minimally invasive foregut surgery, according to a study published in the February issue of the Journal of Thoracic and Cardiovascular Surgery.

Min P. Kim, M.D., of the Weill Cornell Medical College in New York City, and colleagues measured the impact of an enhanced recovery after surgery program plus a preemptive pain-management program, a strategy relying on long-acting anesthesia and scheduled nonopioid pain medication, on surgical outcomes following benign foregut surgery. The authors evaluated this program in comparison to standard care or enhanced recovery after surgery alone in 414 patients who were treated at Houston Methodist Hospital from 2012 to 2018.

The investigators found that the preemptive pain-management program was associated with an opioid prescription rate of 9.6 percent compared with 85.2 percent for the enhanced recovery after surgery alone group and 87 percent in the standard care group. The preemptive pain-management group also experienced fewer postoperative complications (3.2 percent versus 14.8 and 15.1 percent, respectively). Using a multivariable logistic regression analysis, the investigators showed that the preemptive pain-management program was a factor associated with a decrease in opioid prescriptions at discharge (odds ratio, 0.01) and a decrease in postoperative complications (odds ratio, 0.22). One month following surgery, average self-reported pain in a subset of the preemptive pain-management cohort was 0.9 on a 0- to 10-point pain scale.

“The adoption and implementation of this program across multiple disciplines could result in a significant decrease in the availability of opioids in the community, which could lead to a decrease in opioid-related deaths,” the authors write.

Two authors disclosed financial ties to medical technology companies.

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