Utility of enhanced recovery after surgery protocols in reducing postoperative opioid use across different surgical specialties—An analysis of Iowa’s billion pill pledge program

Wali U Pirzada, Simran Shamith, Roland N Leyson, Sara A Khan, Sina Ramtin and Asif M Ilyas

PLOS ONE, 2025, vol. 20, issue 9, 1-11

Abstract: Introduction: The opioid epidemic in the United States poses a major public health challenge, particularly in the context of surgery and perioperative pain management. This study examines the effectiveness of the “Billion Pill Pledge” Enhanced Recovery After Surgery (ERAS) protocols implemented across nine Iowa hospitals, in reducing postoperative opioid prescriptions. Methods: A retrospective chart review was conducted on patients treated by 24 different surgeons at 9 Iowa hospitals from November 2022 to November 2023. Patients were divided into orthopaedic surgery (n = 120) and general surgery (n = 60) groups. Opioid quantities prescribed pre- and post-ERAS implementation were measured and converted to morphine milligram equivalents (MMEs). Statistical analyses included the Wilcoxon-Signed Rank test, Mann-Whitney U test, and Chi-Squared tests. Results: The mean pre-ERAS prescription was 341 MMEs (range: 25–7200 MMEs), which decreased to 151 MMEs (range: 25–2400 MMEs) post-ERAS implementation (p

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0332205

DOI: 10.1371/journal.pone.0332205

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