ArticlePain and therapy2022
The Intraoperative Adherence to Multimodal Analgesia of Anesthesiologists: A Retrospective Study.
Article in Pain and therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Trends in non-opioid analgesic use following major abdominal surgery: a retrospective single-center cohort study.The Korean journal of pain · 2025Article
- Best Evidence Summary for Perioperative Pain Management in Patients With Pectus Excavatum.Pain research & management · 2025Review
- The application of ERAS in the perioperative period management of patients for lung transplantation.Surgery open science · 2024Article
- Developing expert international consensus statements for opioid-sparing analgesia using the Delphi method.BMC anesthesiology · 2023Article
- Analysis of Interventional Application Effect of Ultrasound-Guided QLB and TAPB in the Treatment and Analgesia of Patients Undergoing Laparoscopic Colorectal Surgery.Contrast media & molecular imaging · 2022Article
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Authors and funding
6 authors at 2 institutions in 1 country.
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Abstract
introductionMultimodal analgesia (MMA) is a critical component of enhanced recovery after surgery (ERAS). However, little research revealed its intraoperative implementation by anesthesiologists, who are on the front line defending against surgical pain. Therefore, the objective of our study is to assess the adherence of anesthesiologists to MMA comprehensively.
methodsA retrospective study was conducted involving patients undergoing lung resection, knee arthroplasty, and radical mastectomy from pre/post-implementation year of MMA (Jan 1, 2013, to Dec 31, 2013, vs. 2019). Intraoperative analgesia regimens (analgesic mode) and hourly rated morphine milligram equivalents (MME) were compared. In addition, patient characteristics associated with continued opioid use after surgery, surgical types, and position level of anesthesiologists (attending-junior; above attending-senior) were also analyzed.
resultsAfter MMA initiation, the rate of multimodal analgesic regimen (mode ≥ 2) was significantly increased (post- vs. pre-implementation, 31.57 vs. 21.50%, p < 0.05). However, MME did not show significant difference (post- vs. pre-implementation, 0.402 vs. 0.456, p > 0.05). Patient-level predictors of persistent opioid use after surgery were not related to increased analgesic mode. Lung resection [coefficient, - 0.538; 95% confidence interval (CI), - 0.695 to - 0.383, p < 0.001] and knee arthroplasty (coefficient, - 1.143; 95% CI, - 1.366 to - 0.925, p < 0.001) discouraged multiple analgesic mode, while senior anesthesiologists (coefficient, 0.674; 95% CI 0.548-0.800, p < 0.001) promoted it.
conclusionsAlthough anesthesiologists used more analgesics after promoting MMA, the "opioid-sparing" principle was not followed properly. The analgesic mode was not instructed by patients' characteristics appropriately. In addition, surgeries with cumbersome preparation/process impeded the use of multiple analgesic modes, while senior anesthesiologists preferred multiple analgesic modes.
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