Standardized electronic order sets decreases inpatient opioid use in emergency general surgery

Abstract

Background

Effective pain management while limiting opioids optimizes surgical care. Emergency general surgery (EGS) patients are a vulnerable population and are excluded from enhanced recovery pathways. We examined the effect of standardized pain control order sets for EGS.

Methods

An interprofessionally designed opioid protocol was embedded into admission order sets. Oral and IV morphine milligram equivalents (MME) were monitored from Jan 2019–Jun 2023 for all EGS patients and comparted pre and post-implementation. Primary outcome was total MME and MME per opioid dose administered. Secondary outcomes were pain scores and formulation trends.

Results

Total MME per patient and average MME per dose per patient decreased significantly and were sustained for all administration routes. Lower MME medications were ordered and multimodal regimens increased. Pain scores were stable. MME reduction was sustained over time.

Conclusion

Standardized pain management protocols decreased in-hospital opioid use in EGS.