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

Daniel Da Der Sng; Giulia Uitenbosch; Hans D. de Boer; Hugo Nogueira Carvalho; Juan P. Cata; Gabor Erdoes; Luc Heytens; Fernande Jane Lois; Paolo Pelosi; Anne Françoise Rousseau; Patrice Forget; David Nesvadba; 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

Daniel Da Der Sng^* (Corresponding Author)
, Giulia Uitenbosch
, Hans D. de Boer
, Hugo Nogueira Carvalho
, Juan P. Cata
, Gabor Erdoes
, Luc Heytens
, Fernande Jane Lois
, Paolo Pelosi
, Anne Françoise Rousseau
, Patrice Forget
, David Nesvadba
, Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group

^*Corresponding author for this work

University of Aberdeen
Martini Ziekenhuis
Vrije Universiteit Brussel
University of Texas MD Anderson Cancer Center
University Hospital Bern
University of Antwerp
CHU de Liège
San Martino Hospital Genoa
ESAIC
NHS Grampian

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

13 Citations (Scopus)

7 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
Number of pages	7
Journal	BMC Anesthesiology
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s12871-023-01995-4
Publication status	Published - 27 Feb 2023

Bibliographical note

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

Data Availability Statement

All data generated or analysed during this study are included in this published article [and its supplementary information files].

Funding

The authors have no sources of funding to declare for this manuscript.

Keywords

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

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Cite this

Sng, D. D. D., Uitenbosch, G., de Boer, H. D., Carvalho, H. N., Cata, J. P., Erdoes, G., Heytens, L., Lois, F. J., Pelosi, P., Rousseau, A. F., Forget, P., Nesvadba, D., & Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group (2023). Developing expert international consensus statements for opioid-sparing analgesia using the Delphi method. BMC Anesthesiology, 23(1), Article 62. https://doi.org/10.1186/s12871-023-01995-4

Sng, DDD, Uitenbosch, G, de Boer, HD, Carvalho, HN, Cata, JP, Erdoes, G, Heytens, L, Lois, FJ, Pelosi, P, Rousseau, AF, Forget, P, Nesvadba, D & Pain AND Opioids after Surgery (PANDOS) European Society of Anaesthesiology, Intensive Care (ESAIC) Research Group 2023, 'Developing expert international consensus statements for opioid-sparing analgesia using the Delphi method', BMC Anesthesiology, vol. 23, no. 1, 62. https://doi.org/10.1186/s12871-023-01995-4

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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.",

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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

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AU - Cuvillon, Philippe

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AU - Fettes, Paul

AU - Finco, Gabriele

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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

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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.

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VL - 23

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ER -

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

Abstract

Bibliographical note

Data Availability Statement

Funding

Keywords

Access to Document

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