Robot-assisted laparoscopic nephrectomy: early outcome measures with the implementation of multimodal analgesia and intrathecal morphine via the acute pain service.

Purpose: The objective of this study was to perform a retrospective cohort analysis, in which we measured the association of an acute pain service (APS)-driven multimodal analgesia protocol that included preoperative intrathecal morphine (ITM) compared to historic controls (i.e., surgeon-driven analgesia protocol without ITM) with postoperative opioid use.

Postpartum Acute Aortic Dissection in a Patient Without a Connective Tissue Disorder: A Case Report.

Type A acute aortic dissection is a rare life-threatening event that occurs most commonly in the third trimester or early postpartum and in women with connective tissue disorders. However, this case describes a type A aortic dissection diagnosed on postpartum day 2 in a woman with preeclampsia without a history of a connective tissue disease. The case emphasizes the importance of considering dissection in any parturient complaining of chest pain, especially in the setting of hypertension and a new murmur.

An Update on Racial and Ethnic Differences in Neuraxial Anesthesia for Cesarean Delivery.

Background Racial and ethnic differences in the use of neuraxial anesthesia compared with general anesthesia are less studied, particularly in obstetrical anesthesia. Here, we aimed to provide an update on the association between race and ethnicity, and the use of neuraxial anesthesia for cesarean delivery in the United States (US). Methods We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Participant Use Data File 2019.

The Implementation of an Acute Pain Service for Patients Undergoing Open Ventral Hernia Repair with Mesh and Abdominal Wall Reconstruction.

Introduction: In this retrospective cohort single-institutional study, we report the outcomes of implementing a standardized protocol of multimodal pain management with thoracic epidural analgesia via the acute pain service (APS) for patients undergoing ventral hernia repair with mesh placement and abdominal wall reconstruction.

Methods: The primary outcome evaluated was postoperative 72-h opioid consumption, measured in intravenous morphine equivalents (MEQ). Secondary outcomes included hospital length of stay (LOS) among other outcomes.

Association of trainee involvement in an acute pain service with postoperative opioid use in patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.

Background: Several hospitals have implemented a multidisciplinary Acute Pain Service (APS) to execute surgery-specific opioid sparing analgesic pathways. Implementation of an anesthesia attending-only APS has been associated with decreased postoperative opioid consumption, time to ambulation, and time to solid food intake for patients undergoing cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. In this study, we evaluated the impact of introducing an APS trainee on postoperative opioid consumption in patients undergoing hyperthermic intraperitoneal chemotherapy during POD 0-3.

Association of an acute pain service with postoperative outcomes following pancreaticoduodenectomy.

The aim of this retrospective study was to evaluate the effect of implementing the combination of thoracic epidural analgesia and multimodal analgesia by a dedicated acute pain service on opioid consumption and postoperative outcomes in patients undergoing pancreaticoduodenectomy. Opioid consumption during postoperative days 0-3 was compared in the acute pain service versus non-acute pain service cohort. Between matched cohorts, the median (quartiles) total opioid consumption during postoperative days 0-3 was 114mg morphine equivalents (54.