Mp18-06 enhanced recovery after surgery protocol for percutaneous nephrolithotomy: implications on quality of life and pain management

You have accessJournal of UrologyStone Disease: Surgical Therapy II (MP18)1 Sep 2021MP18-06 ENHANCED RECOVERY AFTER SURGERY PROTOCOL FOR PERCUTANEOUS NEPHROLITHOTOMY: IMPLICATIONS ON QUALITY OF LIFE AND PAIN MANAGEMENT Carol B Girgiss, Erika M Kelly, Emily K Kong, Alec R Flores, Garen Abedi, Seth K Bechis, Manoj Mong, and Roger L Sur Carol B GirgissCarol B Girgiss More articles by this author , Erika M KellyErika M Kelly More articles by this author , Emily K KongEmily K Kong More articles by this author , Alec R FloresAlec R Flores More articles by this author , Garen AbediGaren Abedi More articles by this author , Seth K BechisSeth K Bechis More articles by this author , Manoj MongManoj Mong More articles by this author , and Roger L SurRoger L Sur More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002003.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The opioid epidemic was influenced by excessive opioid prescriptions for pain management. Enhanced recovery after surgery protocols (ERAS) has been demonstrated in ureteroscopy, but not percutaneous nephrolithotomy (PCNL). The objective of this study was to implement ERAS protocol for PCNL and evaluate effects on quality of life and pain management post-operatively. METHODS: Electronic-based medical record ERAS protocol for PCNL was implemented at UC San Diego Urology Department in July 2020. The protocol utilized pain regimen to minimize opioid dependence post-operatively. We prospectively evaluated PCNL patients’ quality of life via the Wisconsin Stone Quality of Life survey (WISQOL) and Patient-Reported Outcomes Measurement System (PROMIS). Patients were assessed preoperatively, at 7 days post-operatively, and 8 weeks after surgery. In addition, opiate usage of post-ERAS implementation of PCNL patients was compared to pre-ERAS cohort. RESULTS: A total of 55 post-ERAS patients completed the WISQOL and PROMIS surveys. A pre-ERAS cohort from 7/2017-12/2017 was selected for comparison of opiate use. Demographic, clinical characteristics and peri-operative data are shown in Table 1. Comparing pain management pre- and post-ERAS implementation, patients received significantly lower amount of opioids, including refills and upon discharge (127.78 morphine milliequivalents vs. 51.27, p=0.0001). Compared to the pre-operative period, post-ERAS cohort had higher quality of life scores at 7 days and 8 weeks and lower pain intensity and pain interference scores at 8 weeks. (Figure 1). CONCLUSIONS: PCNL patients on ERAS protocol had higher quality of life scores at the post-operative period compared to the pre-operative period. Furthermore, compared to a historical cohort, PCNL patients on ERAS protocol utilized significantly less opiates. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e319-e319 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Carol B Girgiss More articles by this author Erika M Kelly More articles by this author Emily K Kong More articles by this author Alec R Flores More articles by this author Garen Abedi More articles by this author Seth K Bechis More articles by this author Manoj Mong More articles by this author Roger L Sur More articles by this author Expand All Advertisement Loading ...