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Doctors may over-prescribe opioids after surgeries


By Robert Preidt
Health Day reporter

MONDAY, June 14, 2021 (HealthDay News) – Many patients who are prescribed opioids after surgery may get the same level of pain relief with non-opioid alternatives such as ibuprofen or acetaminophen without the risk of addiction , according to the researchers.

“Opioids have been part of the routine of postoperative pain care for decades, but the risk that they can lead to persistent use has been clearly documented,” said lead author Dr Ryan Howard, resident of surgery at Michigan Medicine, the University of Michigan scholar. medical center in Ann Arbor.

“Maybe it’s time to make it the exception, not the rule,” he noted in a college press release.

Howard and his colleagues analyzed data from more than 22,000 patients who have undergone any of these common types of surgery – gynecologic, hernia, gallbladder, appendix, bowel, or thyroid.

Opioids were prescribed for 86% of patients; 14% received prescriptions for non-opioid pain relievers.

Within 30 days, 12% of patients in both groups had complications, emergency room visits or re-surgery, according to the study.

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Patients who received non-opioids were slightly more likely to be readmitted to hospital, but rarely due to pain-related issues, the researchers found.

There was no difference between the two groups in the percentage of patients who sought emergency pain care.

Almost 6 in 10 patients responded to a survey about their pain within a week of discharge from hospital and other postoperative issues.

Eighty-two percent of patients in the opioid and non-opioid groups said they were satisfied with their care and 93% had no regrets about having surgery.

However, patients in the non-opioid group were more likely to report no pain in the first week after surgery than those in the opioid group (12% vs. 7%).

They were also more likely to say they had the best possible quality of life after surgery (66% vs. 63%), according to the results, recently published in the journal. Annals of Surgery.

“This study clearly shows no difference in pain, major adverse events, or patient-centered outcomes when opioids are not prescribed,” said lead author Dr Mark Bicket, specialist in health medicine. pain and co-director of Michigan Opioid Prescribe Engagement Network Michigan OPEN).

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He said evidence of the risks of opioid drugs to the patient and to others who might abuse the patient’s remaining prescription pills must be considered, along with evidence of their relative effectiveness for pain control.

In a related study, Michigan OPEN researchers analyzed data from national insurance claims on patients who were not taking opioids prior to surgery.

They found that between 4% and 7% of patients who had surgery requiring a hospital stay and 1.5% to 6.4% of patients who had day surgery filled opioid prescriptions for months. after all surgical pain should have stopped.

According to the study conducted by Michigan OPEN Co-Director Dr. Chad Brummett, patients who experienced this new persistent opioid use received more hospital and emergency care in the year following surgery than those who did. did not fill any opioid prescriptions immediately after their operation.

In the June issue of Journal of Managed Care and Specialty Pharmacy, Brummett’s team reported that patients who started taking opioids after surgery received five times as many opioid prescriptions and had much higher overall health costs than other patients.

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More information

The National Institute on Drug Abuse in the United States has more information on prescription opioids.

SOURCE: Michigan Medicine-University of Michigan, press release, June 10, 2021

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