Impact of a multidisciplinary multimodal opioid minimization initiative in kidney transplant recipients

Clin Transplant. 2020 Oct;34(10):e14006. doi: 10.1111/ctr.14006. Epub 2020 Sep 4.

Abstract

Opioid use after kidney transplant has been shown to be a risk factor for chronic opioid use, which leads to an increased risk of mortality. The purpose of this study was to evaluate the early impact of a multimodal pain regimen and education quality improvement program on opioid use after kidney transplant 2 months after implementation. This was a retrospective, single-center analysis of post-operative opioid use, comparing the average daily Morphine milligram equivalents (MME) of the patients who received education on opioids and a multimodal pain regimen (preoperative TAP/QL block, scheduled APAP and gabapentin) compared to a historical control group. Despite having no differences in pre-transplant opioid exposure, daily and overall inpatient opioid utilization was significantly reduced in the multimodal pain protocol cohort (38.6 vs 8.0 MME/day; P < .001); 5% of patients in the multimodal pain protocol cohort were discharged with an opioid prescription, compared to 96% of controls (P < .001). Our early results demonstrate that a multimodal pain protocol can effectively and dramatically reduce short-term opioid utilization in kidney transplant recipients.

Keywords: kidney transplantation; multimodality pain management; opioid Minimization.

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Humans
  • Kidney Transplantation*
  • Opioid-Related Disorders* / drug therapy
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control
  • Retrospective Studies

Substances

  • Analgesics, Opioid