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Background: The recent opioid epidemic in the United States has damaged the country’s public health system and led to devastating patient outcomes. Healthcare providers are responsible to do their part in reducing these negative consequences.
Purpose: This quality improvement project aimed to develop and implement an evidence-based protocol for an intraoperative lidocaine infusion during gastric surgery. Data was collected to evaluate whether this intervention correlated with reduced postoperative narcotic use and improved patient outcomes.
Methods: Baseline patient outcome data was collected through chart review on 25 patients of Dr. Verseman undergoing gastric surgery prior to protocol implementation. Subsequently, education was provided to the clinical associates of Kalamazoo Anesthesiology regarding the lidocaine protocol components and associated benefits. After implementation, provider adherence to the protocol was assessed, as well as patient outcomes for those who received all components of the lidocaine protocol.
Results: Complete provider adherence to the lidocaine protocol occurred in online nine out of 76 opportunities. Overall, opioid administration was decreased in the lidocaine (protocol) group. Additionally, opioid administration was 78% lower in the lidocaine (protocol) group at 12-24 hours. Cumulative opioid administration over the first 24 hours postoperatively was 46% lower in the lidocaine (protocol) group.
Conclusion: Despite knowledge of current literature and the lidocaine protocol components, anesthesia providers had a low level of adherence to the protocol, overall. Patients who did receive all elements of the lidocaine protocol demonstrated decreased consumption of opioids in the postoperative period. |
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