Abstract：
INTRODUCTION:In this retrospective cohort single-institutional study, we report the outcomes of implementing a standardized protocol of multimodal pain management with thoracic epidural analgesia via the acute pain service (APS) for patients undergoing ventral hernia repair with mesh placement and abdominal wall reconstruction. METHODS:The primary outcome evaluated was postoperative 72-h opioid consumption, measured in intravenous morphine equivalents (MEQ). Secondary outcomes included hospital length of stay (LOS) among other outcomes. The two cohorts were the APS versus non-APS group, in which the former cohort had an APS providing epidural and multimodal analgesia and the latter utilized pain management per surgical team, which mostly consisted of opioid therapy. Using1:1 propensity-score-matched cohorts, Wilcoxon signed-rank test was used to calculate the differences in outcomes. A p < 0.05 was considered statistically significant. RESULTS:There were 83 patients, wherein 51 (61.4%) were in the APS group. Between matched cohorts, the non-APS cohort's median [quartiles] total opioid consumption during the first three days was 85.6 mg MEQs [58.9, 112.8 mg MEQs]. The APS cohort was 31.7 mg MEQs [16.0, 55.3 mg MEQs] (p < 0.0001). The non-APS hospital LOS median [quartiles] was 5 days [4, 7 days] versus 4 days [4, 5 days] in the APS group (p = 0.01). DISCUSSION:A dedicated APS was associated with decreased opioid consumption by 75%, as well as a decreased hospital LOS. We report no differences in ICU length of stay, time to oral intake, time to ambulation or time to urinary catheter removal.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Said ET,Drueding RE,Martin EI,Furnish TJ,Meineke MN,Sztain JF,Abramson WB,Swisher MW,Jacobsen GR,Gosman AA,Gabriel RAdoi
10.1007/s00268-020-05915-2subject
Has Abstractpub_date
2021-01-16 00:00:00eissn
0364-2313issn
1432-2323pii
10.1007/s00268-020-05915-2pub_type
杂志文章abstract：BACKGROUND:The retained knife blade is an unusual and spectacular injury. The aim of this study was to review our experience with the management of such injuries. METHODS:A retrospective chart review of patients with retained knife blades treated at Groote Schuur Hospital Trauma Centre from January 1996 to December 20...
journal_title：World journal of surgery
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更新日期：2010-07-01 00:00:00
abstract：BACKGROUND:The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS:The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therap...
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pub_type： 杂志文章
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pub_type： 杂志文章
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更新日期：2018-09-01 00:00:00
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
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journal_title：World journal of surgery
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更新日期：2008-05-01 00:00:00
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pub_type： 杂志文章
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更新日期：2018-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-4835-z
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更新日期：2011-02-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：1996-09-01 00:00:00
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更新日期：2020-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2012-12-01 00:00:00
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journal_title：World journal of surgery
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doi：10.1007/BF00353738
更新日期：1994-07-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
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更新日期：2012-10-01 00:00:00
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更新日期：2018-06-01 00:00:00
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pub_type： 杂志文章
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更新日期：2018-06-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
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journal_title：World journal of surgery
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更新日期：2015-10-01 00:00:00
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journal_title：World journal of surgery
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更新日期：2009-07-01 00:00:00
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更新日期：2021-03-01 00:00:00
