*Purpose: The opioid epidemic within the United States has devastated patients and their families in addition to triggering a national public health crisis. Unnecessary prescribing of opioids in the post-operative setting is a major contributor to narcotic exposure and harm. In May 2019, our center’s post-operative pain management shifted from opioid minimization to opioid avoidance with a Surgical Opioid Avoidance Protocol (SOAP). The purpose of this evaluation was to assess the impact of SOAP on pain control following renal transplant.

*Methods: A sample size calculation was performed to determine the number of patients needed in each group, pre-SOAP and post-SOAP, to detect a difference of 1 in the primary endpoint, average pain score. Baseline characteristics were collected for each group. Average pain score throughout the renal transplant admission was calculated. As previous opioid minimization strategies at our center have significantly shortened length of stay (LOS), LOS was collected as a secondary endpoint. Pre-SOAP and SOAP pain management regimens are outlined below.

*Results: Overall, power was met and 103 adult renal transplant recipients were included. Demographics were similar in terms of age, gender, race, and BMI (Table 1). Compared to the pre-SOAP pain management strategy, the average pain score was significantly lower in renal transplant recipients utilizing SOAP (2.6 ± 1.7 vs. 1.7 ± 1.3, p=0.002, Table 2). Length of stay was similar between groups.

*Conclusions: Opioid avoidance post-operatively with SOAP is feasible and even significantly reduced average pain score within an adult renal transplant population.

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