title: Utilization of a Preemptive, Multimodal Analgesic Regimen in Adult Ambulatory Septoplasty Patients: A Quality Improvement Project.
abstract: This paper describes a quality improvement project designed to decrease postoperative pain, decrease post-operative nausea and vomiting (PONV), decrease time in the recovery room, and increase patient satisfaction in adult ambulatory septoplasty patients using a multimodal, preemptive analgesic regimen. The project was conducted in a community hospital setting with nine operating rooms, and a twenty one bed recovery room. Project participants included certified registered nurse anesthetists, anesthesiologists, operating room nurses, recovery room nurses, and otolaryngology surgeons. Following a period of departmental education, adult patients scheduled for outpatient septoplasty surgery received a preoperative regimen of medications that included gabapentin, celecoxib, and acetaminophen. Using a pre-post test design, (intervention group n = 17, non-intervention group n = 17) data was collected from patient and analyzed using SPSS version 18.0. The change in practice resulted in a significant decrease in pain scores in the recovery room and on discharge from the recovery room. In addition, patients who received the preemptive regimen also required significantly fewer opioid medications and were ready to be discharged from the recovery room in less time.
authors.forename: Brett
authors.initials: B
authors.lastname: Morgan
authors.forename: Julie
authors.initials: J
authors.lastname: Stanik-Hutt
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000588:Amines / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use*; D000068579:Celecoxib / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D000077206:Gabapentin; D006764:Hospitals, Community; D006801:Humans; D009300:Nasal Septum / Q000601:surgery*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000451:nursing*; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy* / Q000451:nursing*; D011300:Preoperative Care / Q000379:methods*; D058996:Quality Improvement; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D000082:Acetaminophen; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000068579:Celecoxib