How Many Opioid Painkillers Do Surgery Patients Need? New Prescribing Recommendations Unveiled

How many prescription pain pills should a patient receive after breast cancer surgery? Or a hernia repair? Or a gallbladder removal? With the country facing an epidemic of opioid pain medication abuse, the answer should be simple: Just enough to ease patients’ immediate post-surgery pain.

But surgical teams have lacked an evidence-based guide, or even rules of thumb, to help them prescribe powerful opioid pain medications wisely.

A new tool developed at the University of Michigan is now available online for free use by any team that performs 11 common operations. It’s based on data and surveys from surgery patients across the state of Michigan, and on research by U-M researchers who study pain control and surgical quality. 

The new Opioid Prescribing Recommendations for Surgery are just a start. The team behind them hopes to add more types of operations and medications to the list, and to refine the recommendations based on additional research into what patients actually use, and how providers can counsel them about safe opioid pain medication use.

The recommendations were created by the Michigan Opioid Prescribing and Engagement Network, in collaboration with the Michigan Surgical Quality Collaborative, both based at the U-M Institute for Healthcare Policy and Innovation.

Michigan-OPEN researchers have previously shown that when patients are prescribed fewer pills, they consume fewer pills with no changes in pain or satisfaction scores.

So, they focused their first prescribing recommendations on a range of common operations, from hysterectomy and colon surgery to appendectomy and breast biopsy. They give recommended numbers of pills to prescribe to patients who have never taken opioid painkillers before their operation.

The new guide aims to prevent this kind of new chronic opioid use by giving detailed amounts of hydrocodone, oxycodone, tramadol and codeine/acetaminophen in an easy-to-print chart.

The amounts aren’t arbitrary. They represent the actual maximum opioid use reported by three-quarters of actual surgery patients. Most patients actually took far less, from 0 to 5 pills, even when they were prescribed more by their surgeon or other provider.

The new recommendations have already met with positive response among the surgical teams taking part in MSQC, who first received them earlier this month.

Even if surgical teams adopt the new prescribing recommendations, patients will likely have pills left over. That’s why the Michigan-OPEN team has also developed a map that can help Michiganders locate a prescription drug drop.

Newswise has the study

Source: Healthcare Purchasing News