Perioperative Pain Management Research Articles

How Effective is Transversus Abdominis Plane Block in Reducing Pain and Opioid Needs Following Bariatric Surgery?

How Effective is Transversus Abdominis Plane Block in Reducing Pain and Opioid Needs Following Bariatric Surgery?

Effectiveness of implementing a standardized perioperative pain management protocol in children undergoing tonsillectomy: A quality improvement project.

Tonsillectomy procedures are commonly performed worldwide. At our academic tertiary care facility, we perform approximately 1000 tonsillectomy procedures annually. We have found inconsistent pain management strategies in pediatric tonsillectomy patients have contributed to variability in postoperative complications and the number and types of postoperative pain medications required in the Post Anesthesia Care Unit (PACU). This project aimed to assess the impact of implementing a standardized perioperative pain management protocol on reducing postoperative complications in pediatric patients who underwent a tonsillectomy procedure. A pre-post-intervention design was utilized, comparing characteristics and outcomes of pediatric patients for whom a standardized perioperative pain management protocol was implemented over a 12-week period compared to those who did not. The standardized perioperative pain management protocol was utilized intraoperatively by the anesthesiologists, nurse anesthetists, and residents. A Qualtrics survey was used by the Post Anesthesia Care Unit (PACU) nurses to gather data as they cared for patients who underwent tonsillectomy. Four outcomes were measured: (1) postoperative pain medication administration, (2) rate of postoperative respiratory complications, (3) rate of adherence, and (4) usability of a standardized pain management protocol. Data were compared between pre and post-implementation groups. During the quality improvement project, 180 children underwent tonsillectomy, with 81 in the control group and 99 in the intervention group. The median age did not differ between groups. The control group had higher postoperative opioid medication usage (93.8% vs. 54.5%) and a higher number of opioids administered in the recovery room. Postoperative IV fentanyl was reduced in the intervention group (49.4% vs. 28.3% in the intervention, p = .004). Respiratory interventions were more frequent in the control group (24.7% vs. 7.1%), with increased respiratory team activation. Respiratory team activation in the Post Anesthesia Care Unit (PACU) includes a 511 page for anesthesia provider assistance. Respiratory interventions included bag-mask ventilation, lidocaine, propofol or succinylcholine administration, and reintubation. The intervention group had 100% adherence to the pain management protocol, and providers found it easy to use. The quality improvement project highlighted notable improvements in the intervention group for whom a standardized perioperative pain management protocol was used, including reduced opioid medication administration, lower incidence of respiratory interventions, and high adherence to the pain management protocol. These findings underscore the effectiveness and feasibility of standardized protocols in enhancing patient outcomes.

Children and the Opioid Crisis: We Can Make a Difference

The use of opioid-sparing and opioid-free strategies in children can provide adequate analgesia while decreasing the risk of adverse events and contributing to the ongoing battle against the opioid crisis. However, every child must be evaluated individually so that a safe and efficacious perioperative pain management plan can be created. A working knowledge of the risks and benefits of opioids, nonopioid adjuncts, and regional anesthesia along with the ethical considerations for balancing stewardship and beneficent care is essential to the success of these strategies. As perioperative practitioners caring for children, we have an obligation to consider opioid-sparing and opioid-free strategies to promote overall best outcomes. We can make a difference, one child at a time.

Single-Dose Intraoperative Methadone for Pain Management in Pediatric Tonsillectomy: A Randomized Double Blind Clinical Trial.

More than 500,000 elective tonsillectomies are performed in US children annually. Pain after pediatric tonsillectomy is common, often severe, and undertreated. There is no consensus on the optimal management of perioperative tonsillectomy pain. Methadone, with an elimination half-life of 1-2 days, has a longer duration of effect than short-duration opioids such as fentanyl. The primary objective of this study was to investigate the intraoperative use of methadone for pediatric tonsillectomy. It tested the hypothesis that methadone would result in less postoperative opioid use compared with short-duration opioids in children post-tonsillectomy. This double-bind, randomized, parallel group trial in children (3-17 years) undergoing tonsillectomy compared single-dose intravenous methadone (0.1 mg/kg then 0.15 mg/kg age-ideal body weight, in a dose escalation paradigm) versus as-needed short-duration opioid (fentanyl) controls. Opioid use, pain, and side effects were assessed in-hospital and 7 days postoperatively via electronic surveys. The primary outcome was total 7-day opioid use in oral morphine equivalents per kilogram (OME/kg). Secondary outcomes were opioid use in the Post-Anesthesia Care Unit (PACU), daily pain scores, and total number of 7-day opioid doses used. Data analysis included 60 children (20/group), age 5.9±3.7 years (mean±SD; median 4, range 3-17). Total 7-day opioid use (OME/kg median [interquartile range]) was 1.5 [1.2,2.1] in controls, 0.9 [0.1,1.4] after methadone 0.1 mg/kg (P=0.045), and 0.5 [0,1.4] after methadone 0.15 mg/kg (P=0.023). PACU opioid use (OME/kg) in controls was 0.15 [0.1,0.3], 0.04 [0,0.1] after methadone 0.1 mg/kg (P=0.061) and 0.0 [0,0.1] after methadone 0.15mg/kg (P=0.021). Postoperative pain scores were not different between groups. No serious opioid-related adverse events occurred. This small initial study in children undergoing tonsillectomy found that single-dose intraoperative methadone at 0.15 mg/kg age ideal body weight was opioid-sparing compared with intermittent fentanyl.

Multisite prospective study of perioperative pain management practices for anterior cruciate ligament reconstruction in adolescents: Society for Pediatric Anesthesia Improvement Network (SPAIN) Project Report.

Although 200 000 adolescents undergo anterior cruciate ligament reconstruction (ACLR) surgery annually, no benchmarks for pediatric post-ACLR pain management exist. We created a multicenter, prospective, observational registry to describe pain practices, pain, and functional recovery after pediatric ACLR. Participants (n=519; 12-17.5 years) were enrolled from 15 sites over 2 years. Data on perioperative management and surgical factors were collected. Pain/opioid use and Lysholm scores were assessed preoperatively, on postoperative day 1 (POD1), POD3, week 6, and month 6. Descriptive statistics and trends for opioid use, pain, and function are presented. Regional analgesia was performed in 447/519 (86%) subjects; of these, adductor canal single shot was most frequent (54%), nerve catheters placed in 24%, and perineural adjuvants used in 43%. On POD1, POD3, week 6, and month 6, survey response rates were 73%, 71%, 61%, and 45%, respectively. Over these respective time points, pain score >3/10 was reported by 64% (95% CI: 59% to 69%), 46% (95% CI: 41% to 52%), 5% (95% CI: 3% to 8%), and 3% (95% CI: 1% to 6%); the number of daily oxycodone doses used was 2.8 (SD 0.19), 1.8 (SD 0.13), 0, and 0. There was considerable variability in timing and tests for postdischarge functional assessments. Numbness and weakness were reported by 11% and 4% at week 6 (n=315) and 16% and 2% at month 6 (n=233), respectively. We found substantial variability in the use of blocks to manage post-ACLR pain in children, with a small percentage experiencing long-term pain and neurological symptoms. Studies are needed to determine best practices for regional anesthesia and functional assessments in this patient population.

Knowledge-based, computerized, patient clinical decision support system for perioperative pain, nausea and constipation management: a clinical feasibility study.

Opioid administration is particularly challenging in the perioperative period. Computerized-based Clinical Decision Support Systems (CDSS) are a promising innovation that might improve perioperative pain control. We report the development and feasibility validation of a knowledge-based CDSS aiming at optimizing the management of perioperative pain, postoperative nausea and vomiting (PONV), and laxative medications. This novel CDSS uses patient adaptive testing through a smartphone display, literature-based rules, and individual medical prescriptions to produce direct medical advice for the patient user. Our objective was to test the feasibility of the clinical use of our CDSS in the perioperative setting. This was a prospective single arm, single center, cohort study conducted in Strasbourg University Hospital. The primary outcome was the agreement between the recommendation provided by the experimental device and the recommendation provided by study personnel who interpreted the same care algorithm (control). Thirty-seven patients were included in the study of which 30 (81%) used the experimental device. Agreement between these two care recommendations (computer driven vs. clinician driven) was observed in 51 out 54 uses of the device (94.2% [95% CI 85.9-98.4%]). The agreement level had a probability of 86.6% to exceed the 90% clinically relevant agreement threshold. The knowledge-based, patient CDSS we developed was feasible at providing recommendations for the treatment of pain, PONV and constipation in a perioperative clinical setting.Trial registration number & date The study protocol was registered in ClinicalTrial.gov before enrollment began (NCT05707247 on January 26th, 2023).

Time trends in opioid use for patients undergoing hip fracture surgery in 1997-2018: A Danish population-based cohort study.

Although opioids are a mainstay for perioperative pain management in hip fracture patients, no studies have described changes in opioid use over the last two decades. The aim of this study was to describe time trends in opioid use in a population-based cohort of patients undergoing a first-time hip fracture surgery during 1997-2018. Opioid-naïve hip fracture patients >55 years old were identified in Danish medical databases (n = 115,962). By 2-year calendar periods, we calculated prevalence rates (PR) of opioid use in the four quarters after surgery (Q1-Q4). Corresponding prevalence rate ratios (PRR) with 1997-1998 as a reference were estimated with 95% confidence intervals. Further, we calculated the median morphine milligram equivalents (MME) for each quarter. For Q1, the PR of opioid use increased from 29% in 1997-1998 to 78% in 2017-2018 corresponding to a PRR of 2.7 (2.6-2.8). For Q4, the PR was 15% in 1997-1998, peaked in 2003-2004 and then decreased, but stayed high at 13% in 2017-2018. The median MME did not increase when comparing 2017-2018 with 1997-1998, irrespective of the quarter. Tramadol was most frequently used in 1997-1998 shifting to oxycodone in 2017-2018. The PRs of opioid use in Q1 after surgery increased substantially from 1997 to 2018, but this did not translate into increased opioid use up to 1 year after hip fracture surgery or higher dosage. Our findings underline the importance of sustained focus on opioid tapering, dosage and use of opioids with the lowest potential for addiction and other adverse events. Overall, opioid use in Q1 after hip fracture surgery increased 2.7 times from 1997 to 2018, but the doses and opioid use up to 1 year after surgery remained stable. Compared to elderly, younger patients were more likely to use opioid in Q1, while the tendency was opposite in Q2-Q4. The most used opioid type changed from tramadol to oxycodone. Our findings underline the importance of personalized opioid tapering and doses, and use of opioids with the lowest potential for addiction and other adverse events.

Ultrasound Guided Maxillary Nerve Block for Perioperative Pain Management for Patients Undergoing Endoscopic Sinus Surgery: Randomized Control Trial

Background: Proper perioperative pain management remains a cornerstone of well-conducted functional endoscopic sinus surgery (FESS). In such a context, proper pain management entails the adequate provision of prolonged postoperative analgesia, the avoidance of overusing opioids, and consequently limiting their unwanted side effects. Objectives: We aimed to evaluate the effect of bilateral ultrasound-guided suprazygomatic maxillary nerve block (MNB) on postoperative pain in patients undergoing FESS. Methods: Patients eligible for FESS were randomized into two groups: the MNB group (n = 30), who underwent bilateral ultrasound-guided suprazygomatic maxillary nerve block after induction of anesthesia, and a control group (n = 30), who received multimodal analgesia, including opioids. Postoperatively, patients were observed for 48 hours. Pain scores were evaluated upon arrival to the sPACU and at 2, 6, 12, 24, 36, and 48 hours postoperatively, particularly at the time of removal of the hemostatic agent after 36 hours postoperatively. Total rescue analgesia, postoperative complications (including nausea and vomiting [PONV], hypotension, bradycardia, headache), and patient satisfaction were also diligently recorded. Results: Sixty patients who were candidates and underwent FESS surgery were enrolled randomly in both groups. The NRS pain score in the MNB group was significantly lower than that of the control group (P < 0.001), especially the NRS during the removal of the hemostatic agent at T10 was significantly lower in the MNB group (P < 0.001). However, at the 24 - hour point post-surgery, there were no significant differences between both groups (P = 0.568). Total rescue analgesia required was significantly lower in the MNB group compared with the control group (P < 0.001) throughout the first 48 hours postoperatively. The percentage of patients with no postoperative complications (nausea, vomiting, and headache) was higher in the MNB group (76.7 %) compared with the control group (40 %). Patient satisfaction was statistically significantly higher in the MNB group (P < 0.001). Conclusions: Bilateral ultrasound-guided suprazygomatic MNB appeared to be safe and advantageous, as its use was associated with a decrease in total analgesic consumption, a reduction in postoperative morbidities such as pain, nausea, and vomiting, and greater patient satisfaction.

Non-scheduled short-acting opioid to taper off opioids?

This commentary discusses the issues related to the current pharmacotherapy using super long-acting opioids (for the potential convenience for both patients and medical providers) for opioid addiction and argues for the potential to use a non-scheduled short-acting opioid to taper off opioids to reduce total number of patients on opioids and ultimately reduce opioid-related death. This article also proposes to develop short-acting opioids for addiction management instead of the current long-acting regimen. The authors further suggest that dezocine, a previously FDA approved medication for perioperative pain management and a non-scheduled opioid, be brought back to clinical practice in the US as a potential alternative addiction management medication, especially for those who are highly motivated to quit opioids completely using a taper off strategy.

Evaluation of an opioid-free pathway for perineal reconstructive surgery: A 1-year pilot study

ObjectiveTo evaluate the impact of a standardized perioperative pain management pathway on postoperative opioid prescribing practices following male perineal reconstructive surgery at our institution. MethodsPatients undergoing perineal reconstructive surgery (urethroplasty, artificial urinary sphincter, urethral sling) by a single surgeon from July 2022 to June 2023 were prospectively followed. A standardized nonopioid pathway was implemented in the perioperative period. Intraoperative local anesthetic included liposomal bupivacaine mixed with 0.25% bupivacaine. Opioids are administered in the recovery room at the discretion of anesthesiology providers. As of July 2022, our standard practice does not include a postoperative opioid prescription unless pain is poorly controlled in the recovery area. Postoperative communication encounters and opioid prescriptions were tracked through the electronic health record in order to assess the efficacy of an opioid-free pathway. Results67 patients met criteria during the study period, 64/67 performed in an outpatient setting. 6/67 (9%) patients were prescribed an opioid postoperatively; 4 related to post-surgical pain, and 2 related to chronic pain. No refills were prescribed. Of the 26 patients who received an opioid in the recovery area, 2 (7.6%) were prescribed an opioid at discharge. 15/67 (22%) patients had a communication encounter related to pain within 30 days, most commonly related to bladder spasm management. Only 2 of these encounters resulted in an electronic opioid prescription. ConclusionAn opioid-free pathway is appropriate for opioid naïve men undergoing perineal reconstructive surgery. When necessary, electronic opioid prescribing should be employed following discharge for breakthrough pain.

Opioid-Free Analgesia is Safe and Effective in Anterior Cervical Spine Surgery: A Randomized Controlled Trial.

Randomized controlled trial (RCT). Compare the efficacy of a multimodal, opioid-free (OF) pain management pathway with a traditional opioid-containing (OC) pathway in patients undergoing anterior cervical procedures. Previous studies have compared opioid-based pain regimens to opioid-sparing regimens following cervical spine surgery, but have been limited by high rates of crossover, retrospective designs, reliance on indwelling pain catheters, opioid utilization for early postoperative analgesia, and/or a lack of patient-reported outcome measures. This is a RCT in which patients were allocated to either an OF or OC perioperative pain management protocol. Eligible study participants included adult (age up to 18y) patients who underwent primary, 1-level or 2-level anterior cervical surgery [anterior cervical discectomy and fusion (ACDF), anterior cervical disc arthroplasty (ACDA), or hybrid (ACDF and ACDA at different levels)] for degenerative pathology. The primary outcome variable was subjective pain level at 24 hours postoperative. The final study cohort consisted of 50 patients (22 OF, 28 OC). Patients in the OF group reported lower median postoperative pain levels at 6 hours (4 for OF vs. 7 for OC; P=0.041) and 24 hours (3 for OF vs. 5 for OC; P=0.032). At 2-week and 6-week follow-up, pain levels were similar between groups. Patients in the OF group reported greater comfort at 12 hours (9 for OF vs. 5 for OC; P=0.003) and 24 hours (9 for OF vs. 5 for OC; P=0.011) postoperatively. Notably, there were no significant differences in patients' reported pain satisfaction, overall surgical satisfaction, or overall sense of physical and mental well-being. In addition, there were no significant differences in falls, delirium, or constipation postoperatively. A multimodal OF pain management pathway following anterior cervical surgery for degenerative disease results in statistically noninferior pain control and equivalent patient-reported outcome measures compared with a traditional OC pathway.

Current evidence of multimodal anesthesia on postoperative outcomes (ICTRP).

Abstract In times of the opioid crisis in the USA and Europe there is a growing interest in reducing peri- and correlated postoperative opioid consumption and prescription. One approach of dealing with the reduction of opioid application is opioid-free anesthesia (OFA). Despite some uncontestable advantages of OFA, it remains a contentious issue. Multimodal anesthesia (MMA) offers a comprehensive and patient-centered alternative to OFA, and could be considered as a change in paradigm. The goal of MMA is to provide superior perioperative pain management while minimizing the risks and limitations associated with opioids. By improving patient satisfaction, amending pain control, diminishing side effects of opiate utilization, accelerating recovery, alleviation of the opioid crisis and optimization of scarce resources multimodal anesthesia has the potential to transform the field of anesthesiology and perioperative medicine. This systematic review is conducted to examine the current evidence of multimodal anesthesia on postoperative outcomes.

Current evidence of multimodal anesthesia on postoperative outcomes (ClinicalTrials.gov).

Abstract In times of the opioid crisis in the USA and Europe there is a growing interest in reducing peri- and correlated postoperative opioid consumption and prescription. One approach of dealing with the reduction of opioid application is opioid-free anesthesia (OFA). Despite some uncontestable advantages of OFA, it remains a contentious issue. Multimodal anesthesia (MMA) offers a comprehensive and patient-centered alternative to OFA, and could be considered as a change in paradigm. The goal of MMA is to provide superior perioperative pain management while minimizing the risks and limitations associated with opioids. By improving patient satisfaction, amending pain control, diminishing side effects of opiate utilization, accelerating recovery, alleviation of the opioid crisis and optimization of scarce resources multimodal anesthesia has the potential to transform the field of anesthesiology and perioperative medicine. This systematic review is conducted to examine the current evidence of multimodal anesthesia on postoperative outcomes.

Current evidence of multimodal anesthesia on postoperative outcomes (Web of Science).

Abstract In times of the opioid crisis in the USA and Europe there is a growing interest in reducing peri- and correlated postoperative opioid consumption and prescription. One approach of dealing with the reduction of opioid application is opioid-free anesthesia (OFA). Despite some uncontestable advantages of OFA, it remains a contentious issue. Multimodal anesthesia (MMA) offers a comprehensive and patient-centered alternative to OFA, and could be considered as a change in paradigm. The goal of MMA is to provide superior perioperative pain management while minimizing the risks and limitations associated with opioids. By improving patient satisfaction, amending pain control, diminishing side effects of opiate utilization, accelerating recovery, alleviation of the opioid crisis and optimization of scarce resources multimodal anesthesia has the potential to transform the field of anesthesiology and perioperative medicine. This systematic review is conducted to examine the current evidence of multimodal anesthesia on postoperative outcomes.

Current evidence of multimodal anesthesia on postoperative outcomes (Ovid MEDLINE).

Abstract In times of the opioid crisis in the USA and Europe there is a growing interest in reducing peri- and correlated postoperative opioid consumption and prescription. One approach of dealing with the reduction of opioid application is opioid-free anesthesia (OFA). Despite some uncontestable advantages of OFA, it remains a contentious issue. Multimodal anesthesia (MMA) offers a comprehensive and patient-centered alternative to OFA, and could be considered as a change in paradigm. The goal of MMA is to provide superior perioperative pain management while minimizing the risks and limitations associated with opioids. By improving patient satisfaction, amending pain control, diminishing side effects of opiate utilization, accelerating recovery, alleviation of the opioid crisis and optimization of scarce resources multimodal anesthesia has the potential to transform the field of anesthesiology and perioperative medicine. This systematic review is conducted to examine the current evidence of multimodal anesthesia on postoperative outcomes.

Current evidence of multimodal anesthesia on postoperative outcomes (Ovid Embase).

Abstract In times of the opioid crisis in the USA and Europe there is a growing interest in reducing peri- and correlated postoperative opioid consumption and prescription. One approach of dealing with the reduction of opioid application is opioid-free anesthesia (OFA). Despite some uncontestable advantages of OFA, it remains a contentious issue. Multimodal anesthesia (MMA) offers a comprehensive and patient-centered alternative to OFA, and could be considered as a change in paradigm. The goal of MMA is to provide superior perioperative pain management while minimizing the risks and limitations associated with opioids. By improving patient satisfaction, amending pain control, diminishing side effects of opiate utilization, accelerating recovery, alleviation of the opioid crisis and optimization of scarce resources multimodal anesthesia has the potential to transform the field of anesthesiology and perioperative medicine. This systematic review is conducted to examine the current evidence of multimodal anesthesia on postoperative outcomes.

Current evidence of multimodal anesthesia on postoperative outcomes (CINAHL).

Abstract In times of the opioid crisis in the USA and Europe there is a growing interest in reducing peri- and correlated postoperative opioid consumption and prescription. One approach of dealing with the reduction of opioid application is opioid-free anesthesia (OFA). Despite some uncontestable advantages of OFA, it remains a contentious issue. Multimodal anesthesia (MMA) offers a comprehensive and patient-centered alternative to OFA, and could be considered as a change in paradigm. The goal of MMA is to provide superior perioperative pain management while minimizing the risks and limitations associated with opioids. By improving patient satisfaction, amending pain control, diminishing side effects of opiate utilization, accelerating recovery, alleviation of the opioid crisis and optimization of scarce resources multimodal anesthesia has the potential to transform the field of anesthesiology and perioperative medicine. This systematic review is conducted to examine the current evidence of multimodal anesthesia on postoperative outcomes.

Current evidence of multimodal anesthesia on postoperative outcomes (Cochrane Library).

Abstract In times of the opioid crisis in the USA and Europe there is a growing interest in reducing peri- and correlated postoperative opioid consumption and prescription. One approach of dealing with the reduction of opioid application is opioid-free anesthesia (OFA). Despite some uncontestable advantages of OFA, it remains a contentious issue. Multimodal anesthesia (MMA) offers a comprehensive and patient-centered alternative to OFA, and could be considered as a change in paradigm. The goal of MMA is to provide superior perioperative pain management while minimizing the risks and limitations associated with opioids. By improving patient satisfaction, amending pain control, diminishing side effects of opiate utilization, accelerating recovery, alleviation of the opioid crisis and optimization of scarce resources multimodal anesthesia has the potential to transform the field of anesthesiology and perioperative medicine. This systematic review is conducted to examine the current evidence of multimodal anesthesia on postoperative outcomes.

New peptide analgesic, μ1-opioid receptor agonist tafalgin, in multimodal pain management. First results of using in a multidisciplinary hospital

Therapy of chronic pain syndrome and adequate perioperative pain management during treatment of malignant neoplasms are important problems at the current stage of clinical medicine development. Currently, multimodal pain management is effectively applied through drugs of various pharmacological groups prescribed depending on pain intensity in accordance with a digital rating scale. Associated adverse events as well as impossibility of using peroral or transdermal forms in some cases, limit the use of opioid analgesics. High bioavailability and fast absorption of μ1-opioid receptor agonist tafalgin shown during preclinical studies, relatively favorable safety profile allowed to use this drug in oncological clinic.An experience of using tafalgin in treatment of pain syndrome in patients with malignant tumors at the “Lapino” clinical hospital since 2022 is presented. The effectiveness of the drug is evaluated, and its niche in multimodal pain management is determined.

Fascia iliaca catheters for donor site pain after split-thickness skin grafting for acute burn injury: a retrospective review.

The management of acute burn pain poses significant challenges. Regional techniques have become increasingly popular in perioperative burn pain management. Continuous nerve block catheters are particularly useful for split thickness skin grafts where donor site pain can exceed that of the burn-injured site. Donor skin is frequently harvested from the anterolateral thigh. The fascia iliaca (FI) compartment block provides blockade of both the lateral femoral cutaneous nerve and the femoral nerve and thus, it is a useful modality for burn donor pain. Our institution initiated a protocol in which continuous fascia iliaca catheters were placed in patients undergoing split-thickness skin grafting of the anterolateral thigh. This retrospective review seeks to assess the impact of this modality on post-operative pain scores and opioid requirements. Oral morphine equivalent administration was significantly lower in the FI group than the control group starting with POD 0, which is the day of the FI catheter insertion (188 vs 327mg, p<0.001). Over the next 4 postoperative days, OME administration remained lower in the FI group compared to control patients, although not statistically significant on POD 3-4. There was a significant difference in OME administered between the FI group and the control group on POD 5 (159.5 vs 209.2mg, p<0.05). Our retrospective study evaluating the role of fascia iliaca catheters in burn patients undergoing split thickness skin grafting surgery showed significantly lower opioid consumption on postoperative days 1-5 compared to patients without a fascia iliaca catheter.