Utilizing multimodal analgesia to evaluate postoperative analgesic requirements in kidney transplant recipients

Clin Transplant. 2021 Apr;35(4):e14240. doi: 10.1111/ctr.14240. Epub 2021 Feb 22.


The use of non-opioid analgesics following surgery has proven beneficial in managing pain and decreasing adverse outcomes following surgery. Data assessing outcomes related to opioid use is limited in kidney transplant recipients (KTRs). We evaluated the effectiveness of implementing a reduced to no opioid use protocol in KTRs. This retrospective cohort study included adult KTRs between January 2017 and July 2019 with a multimodal analgesic protocol (MAP), focused on limiting opioids, implemented in August 2018. We compared analgesic requirements in morphine milligram equivalents (MME) during transplant admissions between the MAP cohort and traditional cohort. There were 217 KTRs who met the criteria. Inpatient opioid use was significantly reduced in the MAP cohort (16.5 ± 19.2 MME/day vs 24.7 ± 19.7 MME/day; P <.05) with no significant difference in pain scores. No use of opioids within six months of discharge was significantly increased in the MAP cohort (50% vs 7%; P <.001), and there were no reported deaths at six months in either cohort. The use of multimodal analgesia is beneficial in KTRs to provide adequate pain control with limited to no exposure of opioids during admission or at discharge.

Keywords: patient safety; quality of care/care delivery; transplant pharmacist.

MeSH terms

  • Adult
  • Analgesia*
  • Analgesics / therapeutic use
  • Analgesics, Opioid / therapeutic use
  • Humans
  • Kidney Transplantation*
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Retrospective Studies


  • Analgesics
  • Analgesics, Opioid