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Perioperative Medicine
Published in: Perioperative Medicine 1/2017

Open Access 01-12-2017 | Consensus

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) Joint Consensus Statement on Optimal Analgesia within an Enhanced Recovery Pathway for Colorectal Surgery: Part 2—From PACU to the Transition Home

Authors: Michael J. Scott, Matthew D. McEvoy, Debra B. Gordon, Stuart A. Grant, Julie K. M. Thacker, Christopher L. Wu, Tong J. Gan, Monty G. Mythen, Andrew D. Shaw, Timothy E. Miller, For the Perioperative Quality Initiative (POQI) I Workgroup

Published in: Perioperative Medicine | Issue 1/2017

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Abstract

Background

Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver “optimal analgesia”, which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects.

Methods

With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients.

Discussion

As a part of the first Perioperative Quality Improvement (POQI) workgroup meeting, we sought to develop a consensus document describing a comprehensive, yet rational and practical, approach for developing an evidence-based plan for achieving optimal analgesia, specifically for a colorectal surgery within an ERP. The goal was twofold: (a) that application of this process would lead to improved patient outcomes and (b) that investigation of the questions raised would identify knowledge gaps to aid the direction for research into analgesia within ERPs in the years to come. This document details the evidence for a wide range of analgesic components, with particular focus on care in the post-anesthesia care unit, general care ward, and transition to home after discharge. The preoperative and operative consensus statement for analgesia was covered in Part 1 of this paper. The overall conclusion is that the combination of analgesic techniques employed in the perioperative period is not important as long as it is effective in delivering the goal of “optimal analgesia” as set forth in this document.
Footnotes
1
The WA Agency for Medical Directors 2015 Opioid Guideline (last accessed March 24, 2017).
 
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Metadata
Title
American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) Joint Consensus Statement on Optimal Analgesia within an Enhanced Recovery Pathway for Colorectal Surgery: Part 2—From PACU to the Transition Home
Authors
Michael J. Scott
Matthew D. McEvoy
Debra B. Gordon
Stuart A. Grant
Julie K. M. Thacker
Christopher L. Wu
Tong J. Gan
Monty G. Mythen
Andrew D. Shaw
Timothy E. Miller
For the Perioperative Quality Initiative (POQI) I Workgroup
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Perioperative Medicine / Issue 1/2017
Electronic ISSN: 2047-0525
DOI
https://doi.org/10.1186/s13741-017-0063-6

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