Researchers’ mission was to analyze the effect of an Enhanced Recovery After Surgery (ERAS) procedure on the rate of opioid prescription renewals and unplanned patient-provider contacts in the first 30 days after surgery. Using data from a retrospective study approved by an institutional review board (IRB), researchers compared how often patients were prescribed opioids after undergoing minimally invasive gynecologic surgery 10 months before and after the ERAS procedure was put into place. Before and after ERAS was put into place, the researchers compared opioid doses in  morphine milligram equivalents (MMEs), unplanned visits, and phone calls. About 445 patients were included who did not have ERAS implemented, whereas 346 patients who did have ERAS implemented were included. ERAS was linked to lower readmission rates (2% vs. 5.6%, P=0.011) and greater rates of same-day discharge (49% vs. 39%, P=0.003). Postoperative opioid prescriptions were lower for patients who had been treated using the ERAS procedure (197.8 vs. 223.5 MMEs, P=0.0087). Refill requests were lower with ERAS (1.7% vs. 3.6%, P=0.11), although the difference was not statistically significant. Fewer postoperative phone calls were made by patients who had undergone ERAS (38% vs. 46%, P=0.023), including fewer calls relating to pain (10% vs. 16%, P=0.021), and fewer unplanned visits were made by patients who had undergone ERAS (1.5% vs. 5.8%, P=0.001). When the ERAS protocol was put into place, the number of opioid prescriptions given to patients after surgery dropped significantly. Pain-related interactions with clinic staff after surgery were reduced as a result of the ERAS protocol, despite the fact that fewer opioids were provided.

Source: sciencedirect.com/science/article/pii/S0090825822004243