Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery

We compared ICU nonopioid analgesic use, opioid use, and pain before and after Pain, Agitation/Sedation, Delirium, Immobility, and Sleep guideline publication at one academic center among critically ill adults receiving an opioid infusion and greater than or equal to 24 hours of mechanical ventilati...

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Autores principales:	Spencer Sutton, PharmD, Trevor R. McCrobie, PharmD, Mary R. Kovacevic, PharmD, BCCCP, Kevin M. Dube, PharmD, BCCCP, Paul M. Szumita, PharmD, BCCCP, FCCM, Kyle Herod, PharmD, Aaron Bezio, PharmD, Hannah Choi, PharmD, Matthew S. Duprey, PharmD, PhD, BCCCP, Jose Zeballos, MD, John W. Devlin, PharmD, BCCCP, MCCM
Formato:	article
Lenguaje:	EN
Publicado:	Wolters Kluwer 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/1dc8c32a4ac5431f93916f229dce2875
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spelling	oai:doaj.org-article:1dc8c32a4ac5431f93916f229dce28752021-11-25T07:56:44ZImpact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery2639-802810.1097/CCE.0000000000000564https://doaj.org/article/1dc8c32a4ac5431f93916f229dce28752021-10-01T00:00:00Zhttp://journals.lww.com/10.1097/CCE.0000000000000564https://doaj.org/toc/2639-8028We compared ICU nonopioid analgesic use, opioid use, and pain before and after Pain, Agitation/Sedation, Delirium, Immobility, and Sleep guideline publication at one academic center among critically ill adults receiving an opioid infusion and greater than or equal to 24 hours of mechanical ventilation after major surgery. The 2017 (n = 77) and 2019 (n = 57) groups were similar at baseline. The 2019 (vs 2017) patients were more likely to receive scheduled IV/oral acetaminophen (84% vs 69%; p = 0.05), less likely to receive a lidocaine patch (33% vs 50%; p = 0.05), and just as likely to receive ketamine (4% vs 3%; p = 1.0), an nonsteroidal anti-inflammatory drug (7% vs 3%; p = 0.26), or gabapentin/pregabalin (16% vs 9%; p = 0.23). Daily average opioid exposure (in IV morphine milligram equivalent) was not different (70 [42–99] [2017] vs 78 mg [49–109 mg]; p = 0.94). The 2019 (vs 2017) group spent more ICU days with severe pain (p = 0.04). At our center, Pain, Agitation/Sedation, Delirium, Immobility, and Sleep guideline publication had little effect on nonopioid analgesic or opioid prescribing practices in critically ill surgical adults.Spencer Sutton, PharmDTrevor R. McCrobie, PharmDMary R. Kovacevic, PharmD, BCCCPKevin M. Dube, PharmD, BCCCPPaul M. Szumita, PharmD, BCCCP, FCCMKyle Herod, PharmDAaron Bezio, PharmDHannah Choi, PharmDMatthew S. Duprey, PharmD, PhD, BCCCPJose Zeballos, MDJohn W. Devlin, PharmD, BCCCP, MCCMWolters KluwerarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENCritical Care Explorations, Vol 3, Iss 10, p e0564 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Spencer Sutton, PharmD Trevor R. McCrobie, PharmD Mary R. Kovacevic, PharmD, BCCCP Kevin M. Dube, PharmD, BCCCP Paul M. Szumita, PharmD, BCCCP, FCCM Kyle Herod, PharmD Aaron Bezio, PharmD Hannah Choi, PharmD Matthew S. Duprey, PharmD, PhD, BCCCP Jose Zeballos, MD John W. Devlin, PharmD, BCCCP, MCCM Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery
description	We compared ICU nonopioid analgesic use, opioid use, and pain before and after Pain, Agitation/Sedation, Delirium, Immobility, and Sleep guideline publication at one academic center among critically ill adults receiving an opioid infusion and greater than or equal to 24 hours of mechanical ventilation after major surgery. The 2017 (n = 77) and 2019 (n = 57) groups were similar at baseline. The 2019 (vs 2017) patients were more likely to receive scheduled IV/oral acetaminophen (84% vs 69%; p = 0.05), less likely to receive a lidocaine patch (33% vs 50%; p = 0.05), and just as likely to receive ketamine (4% vs 3%; p = 1.0), an nonsteroidal anti-inflammatory drug (7% vs 3%; p = 0.26), or gabapentin/pregabalin (16% vs 9%; p = 0.23). Daily average opioid exposure (in IV morphine milligram equivalent) was not different (70 [42–99] [2017] vs 78 mg [49–109 mg]; p = 0.94). The 2019 (vs 2017) group spent more ICU days with severe pain (p = 0.04). At our center, Pain, Agitation/Sedation, Delirium, Immobility, and Sleep guideline publication had little effect on nonopioid analgesic or opioid prescribing practices in critically ill surgical adults.
format	article
author	Spencer Sutton, PharmD Trevor R. McCrobie, PharmD Mary R. Kovacevic, PharmD, BCCCP Kevin M. Dube, PharmD, BCCCP Paul M. Szumita, PharmD, BCCCP, FCCM Kyle Herod, PharmD Aaron Bezio, PharmD Hannah Choi, PharmD Matthew S. Duprey, PharmD, PhD, BCCCP Jose Zeballos, MD John W. Devlin, PharmD, BCCCP, MCCM
author_facet	Spencer Sutton, PharmD Trevor R. McCrobie, PharmD Mary R. Kovacevic, PharmD, BCCCP Kevin M. Dube, PharmD, BCCCP Paul M. Szumita, PharmD, BCCCP, FCCM Kyle Herod, PharmD Aaron Bezio, PharmD Hannah Choi, PharmD Matthew S. Duprey, PharmD, PhD, BCCCP Jose Zeballos, MD John W. Devlin, PharmD, BCCCP, MCCM
author_sort	Spencer Sutton, PharmD
title	Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery
title_short	Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery
title_full	Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery
title_fullStr	Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery
title_full_unstemmed	Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery
title_sort	impact of the 2018 society of critical care medicine pain, agitation/sedation, delirium, immobility, and sleep guidelines on nonopioid analgesic use and related outcomes in critically ill adults after major surgery
publisher	Wolters Kluwer
publishDate	2021
url	https://doaj.org/article/1dc8c32a4ac5431f93916f229dce2875
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Impact of the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Guidelines on Nonopioid Analgesic Use and Related Outcomes in Critically Ill Adults After Major Surgery

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