What happens when surgeons limit postoperative opioid prescriptions?

What happens when surgeons limit postoperative opioid prescriptions?

What would happen if surgeons limited the number of opioid prescriptions written to manage postoperative pain among patients that had common surgeries? According to a research conducted by a New Hampshire-based general surgeon, physicians would learn that patients actually need fewer pills than they are given, and consequently, there would be a major drop in the number of pills prescribed.

In March, the international journal Annals of Surgery published research in which Richard J. Barth Jr., the chief of general surgery at the Dartmouth-Hitchcock Medical Center, led a team of researchers who surveyed patients undergoing surgical procedures on the amount and nature of prescription pills they were using.

Barth’s team analyzed opioid painkillers provided to patients after five common types of operation: gallbladder removal, partial mastectomy, partial mastectomy with sentinel lymph node biopsy, and two types of hernia repair.

After the researchers found that opioids were significantly overprescribed — just 28 percent of the medications were actually used by the patients — they designed a set of prescribing guidelines, which met about 80 percent of the medical requirements the patients had made but also limited the number of pills they could get.

The set of prescribing guidelines allowed patients to receive 10 painkillers for partial mastectomy with a lymph node biopsy, five for partial mastectomy, and 15 for the other three procedures.

The team also encouraged the 34 surgeons in the medical center to prescribe anti-inflammatory drugs (without steroids) or acetaminophen before resorting to opioids and evaluated how 246 patients were doing after going through the five surgical procedures again.

The average number of opioids prescribed decreased dramatically.

A total of 6,170 pills were… (continue reading)