Evaluation of a Revised Anesthesia Recovery Order Set on Opioid Use and Pain Scores in the Postanesthesia Care Setting at a Rural Health System

Background: Revisions to order sets have proven to be an effective strategy to decrease opioid usage without compromising pain control. However, there is a lack of data to support this strategy in the postanesthesia care setting. Therefore, the objective of this study was to evaluate the effect of a revised anesthesia recovery order set on opioid use and pain scores in adult patients receiving care in the postanesthesia care unit (PACU). Methods: We performed a retrospective, single-center, pre-/post- order set implementation study in adult patients receiving care in the PACU. The primary endpoint was the quantity of opioids administered, measured in morphine milligram equivalents (MMEs). We evaluated the median pain scores in the PACU and the first-reported pain score after leaving the PACU. Results: Morphine milligram equivalent (MME) administered was similar after implementation of the revised anesthesia order set. The median opioids administered was 0.0 MME with the previous order set compared with 0.0 MME with the current order set. There was no difference in median PACU pain score before and after implementation of the new order set (0.0 and 0.0, respectively; P = 0.28). No difference was found for the first-reported pain score after leaving the PACU. Conclusion: There was no significant difference between the quantity of opioids administered and pain scores between the previous and revised anesthesia recovery order set in the postanesthesia care setting. However, further studies with larger sample sizes and a longer study duration may be required to better determine and elucidate the full effects of the changes to the order set.