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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submissionBackground and Aims Laparoscopic cholecystectomies (LC) have become increasingly prevalent showing many benefits, including shorter hospital stays and less postoperative pain, especially when carried out in accordance with PROSPECT recommendations. In the Mercy University Hospital we aimed to carry out an audit in order to examine whether the ESRA PROSPECT recommendations were being followed.Methods We aimed to identify if fentanyl PCAs have been used in accordance with PROSPECT recommendations by retrospectively auditing 53 patient charts. We examined trends in fentanyl PCA use, paying attention to the amounts used up to 72 hours postoperatively and patient satisfaction. Postoperative pain data acquired was use of concomitant analgesics, PRN breakthrough analgesia and patient satisfaction with pain relief. The quantity administered in the immediate 24 hours postoperatively (mcg) and the total quantity during the recovery period were examined.Results The charts of 53 patients were examined, with 17 of those being female and a mean age of 62.55 years. Prescribing in concordance with step 1 of the PROSPECT recommendations occurred in 67.92% of patients. In a previous project we carried out, LCs portrayed a higher mean consumption of fentanyl on day 1 postoperatively of 864 mcg (SD= 586.35) vs. 676.92 mcg (SD= 323.17) in open cholecystectomies. Fentanyl PCAs allowed 88.9% of patients to be ambulatory for every day of their stay and 83.3% of patients were capable to undergo a physiotherapy session. Some level of confusion was seen in 7.55% of patients who received fentanyl PCAs.Abstract P217 Figure 1PROSPECT flow chartAbstract P217 Figure 2DemographicsAbstract P217 Figure 3Choice of analgesics before fentanyl PCAs are introducedConclusions More education on the PROSPECT recommendations should be delivered to any prescribing clinician in the postoperative period. A recommendation to introduce this therapy option to these guidelines as the ‘opioid as rescue’ should be explored, paying particular attention to the increased firing rate of the PCA in the first 24 hours which may be due to pneumoperitoneum.