{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:33:55Z","timestamp":1782995635150,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:00:00Z","timestamp":1610755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:00:00Z","timestamp":1610755200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T00:00:00Z","timestamp":1610755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In this retrospective cohort single\u2010institutional study, we report the outcomes of implementing a standardized protocol of multimodal pain management with thoracic epidural analgesia via the acute pain service (APS) for patients undergoing ventral hernia repair with mesh placement and abdominal wall reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The primary outcome evaluated was postoperative 72\u2010h opioid consumption, measured in intravenous morphine equivalents (MEQ). Secondary outcomes included hospital length of stay (LOS) among other outcomes. The two cohorts were the APS versus non\u2010APS group, in which the former cohort had an APS providing epidural and multimodal analgesia and the latter utilized pain management per surgical team, which mostly consisted of opioid therapy. Using1:1 propensity\u2010score\u2010matched cohorts, Wilcoxon signed\u2010rank test was used to calculate the differences in outcomes. A <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 was considered statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 83 patients, wherein 51 (61.4%) were in the APS group. Between matched cohorts, the non\u2010APS cohort's median [quartiles] total opioid consumption during the first three days was 85.6\u00a0mg MEQs [58.9, 112.8\u00a0mg MEQs]. The APS cohort was 31.7\u00a0mg MEQs [16.0, 55.3\u00a0mg MEQs] (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). The non\u2010APS hospital LOS median [quartiles] was 5\u00a0days [4, 7\u00a0days] versus 4\u00a0days [4, 5\u00a0days] in the APS group (<jats:italic>p<\/jats:italic>\u2009=\u20090.01).\n<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>A dedicated APS was associated with decreased opioid consumption by 75%, as well as a decreased hospital LOS. We report no differences in ICU length of stay, time to oral intake, time to ambulation or time to urinary catheter removal.\n<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05915-2","type":"journal-article","created":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T20:02:30Z","timestamp":1610827350000},"page":"1102-1108","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Implementation of an Acute Pain Service for Patients Undergoing Open Ventral Hernia Repair with Mesh and Abdominal Wall Reconstruction"],"prefix":"10.1002","volume":"45","author":[{"given":"Engy T.","family":"Said","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross E.","family":"Drueding","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin I.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Furnish","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhthy N.","family":"Meineke","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacklynn F.","family":"Sztain","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy B.","family":"Abramson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Swisher","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain Medicine University of California 9400 Campus Point Dr, MC 7770, La Jolla 92037 San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garth R.","family":"Jacobsen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Minimally Invasive Surgery University of California La Jolla San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda A.","family":"Gosman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Plastic Surgery University of California La Jolla San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4443-0021","authenticated-orcid":false,"given":"Rodney A.","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, 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