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American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) Joint Consensus Statement on Optimal Analgesia within an Enhanced Recovery Pathway for Colorectal Surgery: Part 2-From PACU to the Transition Home.

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Date
2017
Authors
Scott, Michael J
McEvoy, Matthew D
Gordon, Debra B
Grant, Stuart A
Thacker, Julie KM
Wu, Christopher L
Gan, Tong J
Mythen, Monty G
Shaw, Andrew D
Miller, Timothy E
Perioperative Quality Initiative (POQI) I Workgroup
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Abstract
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients. DISCUSSION: As a part of the first Perioperative Quality Improvement (POQI) workgroup meeting, we sought to develop a consensus document describing a comprehensive, yet rational and practical, approach for developing an evidence-based plan for achieving optimal analgesia, specifically for a colorectal surgery within an ERP. The goal was twofold: (a) that application of this process would lead to improved patient outcomes and (b) that investigation of the questions raised would identify knowledge gaps to aid the direction for research into analgesia within ERPs in the years to come. This document details the evidence for a wide range of analgesic components, with particular focus on care in the post-anesthesia care unit, general care ward, and transition to home after discharge. The preoperative and operative consensus statement for analgesia was covered in Part 1 of this paper. The overall conclusion is that the combination of analgesic techniques employed in the perioperative period is not important as long as it is effective in delivering the goal of "optimal analgesia" as set forth in this document.
Type
Journal article
Subject
Analgesia
Colorectal surgery
Enhanced recovery pathway
Multimodal
Non-opioid adjuncts
Optimal analgesia
Outcomes
Pain management
Post-discharge
Postoperative
Quality
Permalink
https://hdl.handle.net/10161/14226
Published Version (Please cite this version)
10.1186/s13741-017-0063-6
Publication Info
Scott, Michael J; McEvoy, Matthew D; Gordon, Debra B; Grant, Stuart A; Thacker, Julie KM; Wu, Christopher L; ... Perioperative Quality Initiative (POQI) I Workgroup (2017). American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) Joint Consensus Statement on Optimal Analgesia within an Enhanced Recovery Pathway for Colorectal Surgery: Part 2-From PACU to the Transition Home. Perioper Med (Lond), 6. pp. 7. 10.1186/s13741-017-0063-6. Retrieved from https://hdl.handle.net/10161/14226.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Grant

Stuart Alan Grant

Professor of Anesthesiology
My research interests include regional anesthesia, acute pain management, and ambulatory anesthesia. Our regional anesthesia group have particular interest in resident education and ultrasound guided nerve block. We also have an interest in the use of continuous peripheral catheter systems and liposomal drug delivery systems for prolonged post operative analgesia. We also investigate the effects of regional anesthesia on patient outcomes. My ambulatory anesthesia research interes
This author no longer has a Scholars@Duke profile, so the information shown here reflects their Duke status at the time this item was deposited.
Miller

Timothy Ellis Miller

Professor of Anesthesiology
Clinical and research interests are Enhanced Recovery and Perioperative Medicine; with particular interests in fluid management, and perioperative optimization of the high-risk non-cardiac surgery patient.
Thacker

Julie K. Marosky Thacker

Associate Professor of Surgery
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