Developing expert international consensus statements for opioid-sparing analgesia using the Delphi method

BMC Anesthesiology

Research

Hugo Nogueira Carvalho¹  Anne-Françoise Rousseau²  Fernande Jane Lois³  Patrice Forget⁴  David Nesvadba⁵  Luc Heytens⁶  Hans D. de Boer⁷  Juan P. Cata⁸  Paolo Pelosi⁹  Giulia Uitenbosch^1,10  Daniel Da Der Sng^1,10  Gabor Erdoes^1,11 

[1] Anesthesiology and Perioperative Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Jette, Belgium;Centre Des Brûlés, Centre Hospitalier Universitaire de Liège, Liège, Belgium;Centre Hospitalier Universitaire de Liège, Anesthesiology, Liège, Belgium;Department of Anaesthesia, Institute of Applied Health Sciences, Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen; NHS Grampian, AB25 2ZD, Aberdeen, UK;Pain and Opioids After Surgery (PANDOS) European Society of Anaesthesiology and Intensive Care (ESAIC) Research Group, ESAIC, Brussels, Belgium;Department of Anaesthesia, NHS Grampian, AB25 2ZD, Aberdeen, UK;Department of Anesthesia, Department of Neurology and Instituut Born-Bunge, University of Antwerp (UA), Antwerpen, Belgium;Department of Anesthesiology Pain Medicine and Procedural Sedation and Analgesia, Martini General Hospital Groningen, Groningen, Netherlands;Department of Anesthesiology and Perioperative Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, USA;Department of Surgical Sciences and Integrated Diagnostics (DISC), IRCCS San Martino Policlinico Hospital, Genova GE, Italy;School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, AB25 2ZD, Aberdeen, UK;University Department of Anaesthesiology and Pain Medicine, Inselspital, University Hospital Bern, Bern, Switzerland;

关键词: Opioids;    Opioid-sparing;    Delphi;   

DOI  :  10.1186/s12871-023-01995-4

 received in 2022-11-06, accepted in 2023-01-25,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionThe management of postoperative pain in anaesthesia is evolving with a deeper understanding of associating multiple modalities and analgesic medications. However, the motivations and barriers regarding the adoption of opioid-sparing analgesia are not well known.MethodsWe designed a modified Delphi survey to explore the perspectives and opinions of expert panellists with regard to opioid-sparing multimodal analgesia. 29 anaesthetists underwent an evolving three-round questionnaire to determine the level of agreement on certain aspects of multimodal analgesia, with the last round deciding if each statement was a priority.ResultsThe results were aggregated and a consensus, defined as achievement of over 75% on the Likert scale, was reached for five out of eight statements. The panellists agreed there was a strong body of evidence supporting opioid-sparing multimodal analgesia. However, there existed multiple barriers to widespread adoption, foremost the lack of training and education, as well as the reluctance to change existing practices. Practical issues such as cost effectiveness, increased workload, or the lack of supply of anaesthetic agents were not perceived to be as critical in preventing adoption.ConclusionThus, a focus on developing specific guidelines for multimodal analgesia and addressing gaps in education may improve the adoption of opioid-sparing analgesia.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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