The impact of reducing opioid unit dose quantities on perioperative utilization and pain scores for laparoscopic cholecystectomies.

At our institution, reductions to hydromorphone and fentanyl unit dose quantities provided us with a unique opportunity to study opioid utilization. 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). 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. 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.