Post-POP surgery opioids can be decreased without affecting patient satisfaction

  • Linder BJ & al.
  • Am J Obstet Gynecol
  • 18 Jun 2019

  • International Clinical Digest
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Takeaway

  • Procedure-specific recommendations can reduce the number of opioids prescribed after pelvic organ prolapse (POP) surgery by nearly half, without adversely affecting patient satisfaction.

Why this matters

  • These findings may help other practices evaluate their own opioid prescribing patterns after POP surgery.

Study design

  • Researchers studied patients undergoing vaginal, abdominal, or robotic prolapse surgery either before or after implementation of procedure-specific opioid prescribing recommendations (N=96).
  • They based prescribing guidelines on amounts that would fully supply the needs of 80% of patients for each specific surgery.
  • Funding: Rochester Sisters of Saint Francis.

Key results

  • After implementation of the recommendations, prescribed median oral morphine equivalents (OME) decreased from 200 mg (interquartile range [IQR], 150-225 mg) to 112.5 mg (IQR, 22.5-112.5 mg; P<.0001>
  • Leftover OME per patient also decreased from 112.5 mg (IQR, 48.8-217.5 mg) to 15 mg (IQR, 0-97.5 mg; P<.0001>
  • The percentage of patients requesting pain medication refills increased from 3.5% to 18% (P=.03).
  • Scores measuring patient satisfaction with postdischarge pain management remained the same (9/10; IQR, 8-10; P=.87).

Limitations

  • The study was single-center with a small sample size.
  • Results may not apply to patients with previous opioid use.