October 25, 2017

Standardized ambulatory surgery protocol reduces postop pain, ED visits

By: Judy Mathias

Editor’s Note

Standardizing clinical processes for outpatient hernia repairs reduced postoperative pain and unplanned returns to the emergency department (ED), finds this study presented October 23 at the American College of Surgeons 2017 Clinical Congress in San Diego.

Researchers developed a standardized eight-step protocol that incorporated best practices and enhanced recovery after surgery (ERAS) concepts. The study included data on 2,390 patients who had outpatient open inguinal hernia repairs using the standardized protocol between 2015 and 2016.

Two aspects of the protocol that particularly influenced outcomes were preoperative patient education and use of monitored anesthesia care (MAC) instead of general anesthesia. Patients who received preoperative education were less likely to return to the hospital in the immediate postoperative period. Those with MAC had lower postoperative pain scores than general anesthesia patients.

The researchers are now rolling the standardized protocol out to additional surgical specialties across Kaiser Permanente Southern California.



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