Perioperative anesthetic care and postoperative pain management
verbal pain, RA, Pain, pain
ADVERSE EVENTS
A standardized balanced anesthetic technique was used in all patients per routine care. In general anesthesia (GA), patients received an induction dose of propofol, opioid (fentanyl and/or hydromorphone), an inhalational agent (sevoflurane or desflurane), and a muscle relaxant (rocuronium). The muscle relaxant was reversed with neostigmine and atropine. In regional anesthesia (RA), patients received spinal anesthetic and sedation using midazolam, fentanyl and a propofol infusion (20–150 mcg/kg/min). Use of intrathecal opioid (100 mcg preservative free morphine) was at the discretion of the anesthesiologist. Both groups received intravenous or oral narcotics in the postoperative period guided by the Acute Pain Service team, as per our institutional standard of care. Pain was evaluated on a score of 0–10, with 0 as no pain and 10 as the most excruciating pain. Intravenous morphine by patient-controlled analgesia was initiated when the verbal pain score was 4 or higher. The research assistant visited patients daily to assist them with application and removal of the portable PSG, collect data, and document adverse events during the hospital stay.