Aim: At our institution, reductions to hydromorphone and fentanyl unit dose quantities provided us with a unique opportunity to study opioid utilization. Materials & methods: A retrospective study examining effects of changes in opioid unit dose on intra-operative and postoperative opioid utilization in patients who underwent laparoscopic cholecystectomy. The study included three arms: the predosage change (n = 254), fentanyl only change group (n = 102) and the postdosage change arm (n = 254). Results: Decreasing opioid unit dosing decreased intraoperative opioid administration and total perioperative utilization. Decreased postanesthesia care unit morphine milligram equivalent (MME) requirements were observed in all, but one group comparison. Conclusion: Our data suggests that opioid unit dosing and administration are directly proportional and that decreased intraoperative MME utilization leads to decreased total perioperative MME use.
Keywords: opioids; pain; pain management; postoperative pain.
This study suggests that by supplying anesthesia providers with smaller quantities of opioid pain medication for use during surgery less pain medication is used both during and after surgery without a resultant increase in a patient’s pain score or the amount of time they need to stay in the postoperative recovery area. As a result, some of the negative side effects associated with opioid pain medications may be diminished.