Surgical opioid-avoidance protocol: a postoperative pharmacological multimodal analgesic intervention in diverse patient populations.

INTRODUCTION: This study evaluated the effect of a surgical opioid-avoidance protocol (SOAP) on postoperative pain scores. The primary goal was to demonstrate that the SOAP was as effective as the pre-existing non-SOAP (without opioid restriction) protocol by measuring postoperative pain in a diverse, opioid-naive patient population undergoing inpatient surgery across multiple surgical services. METHODS: This prospective cohort study was divided into SOAP and non-SOAP groups based on surgery date. The non-SOAP group had no opioid restrictions (n=382), while the SOAP group (n=449) used a rigorous, opioid-avoidance order set with patient and staff education regarding multimodal analgesia. A non-inferiority analysis assessed the SOAP impact on postoperative pain scores. RESULTS: Postoperative pain scores in the SOAP group compared with the non-SOAP group were non-inferior (95% CI: -0.58, 0.10; non-inferiority margin=-1). The SOAP group consumed fewer postoperative opioids (median=0.67 (IQR=15) vs 8.17 morphine milliequivalents (MMEs) (IQR=40.33); p<0.01) and had fewer discharge prescription opioids (median=0 (IQR=60) vs 86.4 MMEs (IQR=140.4); p<0.01). DISCUSSION: The SOAP was as effective as the non-SOAP group in postoperative pain scores across a diverse patient population and associated with lower postoperative opioid consumption and discharge prescription opioids.

Exposure of workers in tanneries, construction and beauty salons in Armenia to occupational environmental pollution. Case study

The objective of this research was to evaluate the working and health conditions of workers in three sectors of the economy of Armenia, Colombia (tanneries, construction sites, and beauty salons) exposed to chemical and physical agents. A descriptive observational study of the working conditions and health of workers in their work environments was carried out, by visiting 10 companies per sector. The evaluation of working conditions in construction sites gave High (high risk), as well as in tanneries. Beauty salons gave an evaluation of Medium (medium risk).

El objetivo de esta investigación fue evaluar las condiciones de trabajo y salud de los trabajadores, de tres sectores de la economía de Armenia, Colombia (curtiembres, obras de construcción y salones de belleza), expuestos a agentes químicos y físicos. Se realizó un estudio observacional descriptivo de las condiciones de trabajo y salud de los trabajadores en sus entornos laborales, visitando 10 empresas por sector. La evaluación de las condiciones de trabajo en las obras de construcción dio un resultado Alto (riesgo elevado), al igual que en las curtiembres. Los salones de belleza obtuvieron una evaluación Media (riesgo medio).