Opioid prescriptions for six surgeries down by half, study says

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News ID: 40156
Publish Date: 9:28 - 01 June 2019
TEHRAN, Jun 1-More than half of the patients included in a study who had one of six surgeries took no opioids after the procedure, researchers say.

Opioid prescriptions for six surgeries down by half, study saysTEHRAN, Young Journalists Club (YJC) -Between 2010 and 2016, new opioid prescriptions from surgeons have increased by 18 percent, new findings show. At the same time, physicians have started prescribing alternative pain killers, like acetaminophen and ibuprofen, to help slow that trend -- and it may be be effective.

More than half of patients who underwent one of six surgeries took no opioids after the procedure, according to a study published Thursday in the Journal of the American College of Surgeons.

"We think a fundamental root cause of the opioid epidemic is opioid-naïve patients getting exposed to opioids and then really struggling to stop taking them postoperatively, and then moving on to chronic opioid use, abuse, addiction, and overdose," Michael Englesbe, a researcher at the University of Michigan and study author, said in a news release.

For this study, he said, the goal was to have a majority of patients need no opioid pills after their operations.

The study involved 190 "opioid-naive" patients who underwent one of six surgeries: laparoscopic cholecystectomy, laparoscopic inguinal hernia repair, thyroidectomy/parathyroidectomy, robotic prostatectomy, endoscopic sinus operations or laparoscopic sleeve gastrectomy.

After their surgeries, the patients had to alternate taking 650 mg of acetaminophen and 600 mg of ibuprofen every three hours to reduce the pain. The patients also received a prescription for a small number of opioids, mainly oxycodone, to take if the pain became uncontrollable.

The patients were asked to report how many opioids they used after the operation.

In the first week following their procedures, the patients rated their pain on a scale of 0 (no pain) to 3 (severe pain). The median score among all patients was 1 (minimal pain), and for patients who used opioids, it was 2. This suggests the opioids didn't necessarily help patients to manage pain.

In all, 91 percent of patients reported the strategy helped them to manage pain.

Even with doctors placing so much emphasis on prescribing fewer opioids, however, the researchers think the drugs still have their place.

"Just not giving opioids is not the answer -- we have to give the best pain care," Englesbe said. "From the beginning, everyone was on the same page with talking to patients about their pain and letting them know that operations hurt."

Englesbe says taking a minimal approach to prescribing opioids might not work with all patients. Doctors, he says, must do what works for the individual patient.

Moving forward, the researchers are planning future studies using the same strategy on a group of patients who undergo one of 18 surgeries.

"Our overall goal is to have half the operations done in the state of Michigan without patients needing opioids and still getting excellent pain care," Englesbe said. "There are alternatives to opioids for surgical pain that work well and we should be using them more."

Source: upi

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