Faulkner Heather R, Coopey Suzanne B, Sisodia Rachel, Kelly Bridget N, Maurer Lydia R, Ellis Dan
Division of Plastic Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Division of Surgical Oncology, Allegheny Health Network, Wexford, Pennsylvania, USA.
JPRAS Open. 2021 Oct 26;31:22-28. doi: 10.1016/j.jpra.2021.10.006. eCollection 2022 Mar.
Enhanced recovery after surgery (ERAS) protocols are effective at reducing inpatient opiate use. There is a paucity of studies on the effects of an ERAS protocol on outpatient opiate prescriptions. The aim of this study was to determine whether an ERAS protocol for plastic and reconstructive surgery would reduce opiate use in the outpatient postoperative setting.
A statewide (Massachusetts, USA) controlled substance prescription monitoring database was retrospectively reviewed to assess the prescribing patterns of a single academic plastic surgeon performing common plastic surgical outpatient operations. The time period prior to implementation of the ERAS protocol was then compared with the time period following protocol implementation. An additional three months of post-implementation data were then compared with those of each of the previous time periods to investigate whether the results were sustained.
A comparison of opiate prescriptions in pre-ERAS, immediate post-ERAS procedures, and follow-up ERAS implementation procedures revealed a statistically significant decrease in opiate prescriptions after ERAS protocol implementation. This decrease in the quantity of opiates prescribed was sustained over time
ERAS protocols are effective at reducing outpatient opiate prescriptions after a variety of plastic surgery operations. Appropriate patient and physician education is paramount for success.
术后加速康复（ERAS）方案在减少住院患者阿片类药物使用方面有效。关于ERAS方案对门诊阿片类药物处方影响的研究较少。本研究的目的是确定整形和重建手术的ERAS方案是否会减少门诊术后阿片类药物的使用。
回顾性分析一个全州范围（美国马萨诸塞州）的受控物质处方监测数据库，以评估一位进行常见整形门诊手术的学术型整形外科医生的处方模式。然后将ERAS方案实施前的时间段与方案实施后的时间段进行比较。随后将实施后额外三个月的数据与之前每个时间段的数据进行比较，以研究结果是否持续。
对ERAS实施前、ERAS实施后即刻以及ERAS实施后随访程序中的阿片类药物处方进行比较，结果显示ERAS方案实施后阿片类药物处方有统计学意义的减少。随着时间的推移，所开阿片类药物数量的减少持续存在。
ERAS方案在减少各种整形手术后的门诊阿片类药物处方方面有效。适当的患者和医生教育是成功的关键。
