Gastroenterology & Endoscopy News 4/12/24: Pain Management Protocol Reduces Opioid Use in Hospitalized IBD Patients

“Dr. Berry and his co-investigators developed the Proactive Analgesic Inpatient Narcotic-Sparing (P.A.I.N.-Sparing) protocol. The approach relies on scheduled nonopioid pain medications tailored to the severity of a patient’s pain (Figure). However, patients have the option to request opioid medication for uncontrolled breakthrough pain.”

Open Access! Berry, S.K., Takakura, W., Patel, D. et al. A randomized controlled trial of a proactive analgesic protocol demonstrates reduced opioid use among hospitalized adults with inflammatory bowel disease. Sci Rep 13, 22396 (2023). https://doi.org/10.1038/s41598-023-48126-0

The authors conducted a randomized controlled trial in hospitalized patients with IBD (n=33) to evaluate the impact of a proactive opioid-sparing analgesic protocol. 

Key findings:

Those randomized to the intervention tended to have lower pain scores than the control group regardless of hospital day (3.02 ± 0.90 vs. 4.29 ± 0.81, p = 0.059), used significantly fewer opioids (daily MME 11.8 ± 15.3 vs. 30.9 ± 42.2, p = 0.027), and had a significantly higher step count by Day 4 (2330 ± 1709 vs. 1050 ± 1214; p = 0.014)

My take: It is a good idea to have a set pain management pathway –especially if it works to reduce pain and reduce the risk of excess opioid use.

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