• BMC anesthesiology · Feb 2023

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

    • Daniel Da Der Sng, Giulia Uitenbosch, Hans D de Boer, CarvalhoHugo NogueiraHNAnesthesiology and Perioperative Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Jette, Belgium., Juan P Cata, Gabor Erdoes, Luc Heytens, Fernande Jane Lois, Paolo Pelosi, Anne-Françoise Rousseau, Patrice Forget, David Nesvadba, and Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group.
    • School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK. danielsng96@gmail.com.
    • BMC Anesthesiol. 2023 Feb 27; 23 (1): 6262.

    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.© 2023. The Author(s).

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