Archive October 2014 XV, No. 10

The Surgeons' Lounge: Pain Control

Should We Switch to Non-Opioid IV Pain Meds?

Carrie White, RN, BSN

BIO

— PAIN STUDY Surgical unit RNs conducted a study to find out how a non-opioid IV analgesic given pre-operatively compared to morphine and fentanyl.

PAIN CONTROL Should We Switch to Non-Opioid IV Pain Meds?

One of our general surgeons wanted to know if giving her laparoscopic hernia and cholecystectomy patients a non-opioid, non-NSAID, intravenous analgesic pre-operatively would reduce the use of opioids, reduce pain and improve discharge times. To find out, we performed an evidence-based study in our unit at the Surgery Center at Virginia Baptist Hospital in Lynchburg, Va.

First, we added a standing order to the surgeon's order set that included 1 gram IV of the analgesic given pre-operatively in the holding room. For 6 months, from February to July 2013, we gave this medication to all the surgeon's laparoscopic hernia and cholecystectomy patients who were between the ages of 18 and 50.

We completed data collection sheets on each patient who fell into the category for this study. The data we collected included:

  • medical record and account number;
  • pre-operative pain;
  • IV analgesic (yes or no);
  • rescue medications (morphine, dilaudid, fentanyl or pain pill);
  • arrival time at surgery center to post-op (minutes);
  • discharge pain (rated on a numeric scale of 0 to 10); and
  • discharge time from surgery center (minutes).

The retrospective data collection was much harder. The time period for this data was before the use of IV analgesic, from January to June 2010. The data analyst at our hospital created a list of 54 random patients with the specific criteria we were looking for, as noted above in the data collection list. We had to dig through our computer system to look up this information. It was a very time-consuming process.

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