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

Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group

doi:10.1186/s12871-023-01995-4

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

Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

3 Downloads (Pure)

Abstract

INTRODUCTION: The 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.

METHODS: We 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.

RESULTS: The 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.

CONCLUSION: Thus, a focus on developing specific guidelines for multimodal analgesia and addressing gaps in education may improve the adoption of opioid-sparing analgesia.

Original language	English
Article number	62
Journal	BMC Anesthesiology
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s12871-023-01995-4 https://doi.org/10.1186/s12871-023-01995-4
Publication status	Published - 27 Feb 2023

Bibliographical note

Funding Information:
We would like to thank our supervisors, panellists and contributors for making this project possible.

Publisher Copyright:
© 2023, The Author(s).

Keywords

Analgesics, Opioid/therapeutic use
Delphi Technique
Educational Status
Analgesia
Pain Management

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Cite this

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title = "Developing expert international consensus statements for opioid-sparing analgesia using the Delphi method",

abstract = "INTRODUCTION: The 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.METHODS: We 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.RESULTS: The 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.CONCLUSION: Thus, a focus on developing specific guidelines for multimodal analgesia and addressing gaps in education may improve the adoption of opioid-sparing analgesia.",

keywords = "Analgesics, Opioid/therapeutic use, Delphi Technique, Educational Status, Analgesia, Pain Management",

author = "Sng, {Daniel Da Der} and Giulia Uitenbosch and {de Boer}, {Hans D.} and Carvalho, {Hugo Nogueira} and Cata, {Juan P.} and Gabor Erdoes and Luc Heytens and Lois, {Fernande Jane} and Paolo Pelosi and Rousseau, {Anne Fran{\c c}oise} and Patrice Forget and David Nesvadba and Sadegh Abdolmohammadi and Gebrehiwot Asfaw and Daniel Benhamou and Gilbert Blaise and Philippe Cuvillon and Tahan, {Mohamed El} and Emmanuel Feldano and Paul Fettes and Gabriele Finco and Michael Fitzpatrick and Atul Kapila and Callum Kaye and Vikas Kaura and Helen May and Patrick Meybohm and Ulrike Stamer and Daniel Taylor and {Van De Velde}, Marc and {Van Pee}, Benoit and {Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group}",

note = "Funding Information: We would like to thank our supervisors, panellists and contributors for making this project possible. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

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doi = "10.1186/s12871-023-01995-4",

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AU - Sng, Daniel Da Der

AU - Uitenbosch, Giulia

AU - de Boer, Hans D.

AU - Carvalho, Hugo Nogueira

AU - Cata, Juan P.

AU - Erdoes, Gabor

AU - Heytens, Luc

AU - Lois, Fernande Jane

AU - Pelosi, Paolo

AU - Rousseau, Anne Françoise

AU - Forget, Patrice

AU - Nesvadba, David

AU - Abdolmohammadi, Sadegh

AU - Asfaw, Gebrehiwot

AU - Benhamou, Daniel

AU - Blaise, Gilbert

AU - Cuvillon, Philippe

AU - Tahan, Mohamed El

AU - Feldano, Emmanuel

AU - Fettes, Paul

AU - Finco, Gabriele

AU - Fitzpatrick, Michael

AU - Kapila, Atul

AU - Kaye, Callum

AU - Kaura, Vikas

AU - May, Helen

AU - Meybohm, Patrick

AU - Stamer, Ulrike

AU - Taylor, Daniel

AU - Van De Velde, Marc

AU - Van Pee, Benoit

AU - Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group

PY - 2023/2/27

Y1 - 2023/2/27

N2 - INTRODUCTION: The 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.METHODS: We 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.RESULTS: The 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.CONCLUSION: Thus, a focus on developing specific guidelines for multimodal analgesia and addressing gaps in education may improve the adoption of opioid-sparing analgesia.

AB - INTRODUCTION: The 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.METHODS: We 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.RESULTS: The 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.CONCLUSION: Thus, a focus on developing specific guidelines for multimodal analgesia and addressing gaps in education may improve the adoption of opioid-sparing analgesia.

KW - Analgesics, Opioid/therapeutic use

KW - Delphi Technique

KW - Educational Status

KW - Analgesia

KW - Pain Management

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DO - 10.1186/s12871-023-01995-4

M3 - Article

C2 - 36849928

SN - 1471-2253

VL - 23

JO - BMC Anesthesiology

JF - BMC Anesthesiology

IS - 1

M1 - 62

ER -

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

Abstract

Bibliographical note

Keywords

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