SUFU 2018: Opioid Prescribing Practices and Medication Use After Urogynecological Surgery
This is a prospective observational study of female patients who underwent urogynecologic surgery from June to August 2017 by four physicians. Patients were called 30 days following their surgery and were questioned regarding pain medication usage. Questions included preoperative opioid use, number used, and refill need.
Dr. Shirly Solouki and colleagues reported that 60 patients were contacted, 43 patients responded. Median age was 60 (IQR 53-71), median BMI was 28 (IQR 25-31) and race breakdown was 58% Hispanic, 20.9% Black, 7% Caucasian. There was no statistically significant difference in age, BMI and race between responders and non-responders. 70% of responders had vaginal surgery, 25.6% robotic or laparoscopic surgery, and 4% underwent other procedures (e.g.sacral neuromodulation). Postoperatively, 18% (n=11) of patients were not prescribed any opioids. The median number of opioid tablets prescribed was 12. 16.2% used no opioids, 39.5% of patients used 1-49% of their prescribed opioids, 9.3% used 50-99% of their opioids, and 34.9% of patients used all of their prescribed opioids. There was no difference in opioid prescription or usage patterns between those who underwent vaginal vs. robotic/laparoscopic surgery.
The authors reports that the opioids are overprescribed post-operatively with 55% of patients using less than half of the opioids prescribed to them. They said this ongoing study will be used to create postoperative opioid prescribing guidelines to minimize overprescribing opioids while still adequately controlling postoperative pain.
Presented by: Shirly Solouki MD, Montefiore, Bronx, NY
Co Authors: Melissa Plummer MD, Einstein, Bronx, NY and Nitya Abraham MD, Montefiore, Bronx, NY
Written by: Bilal Farhan, MD, Female Urology Fellow and Voiding Dysfunction, Department of Urology, University of California, Irvine at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting (SUFU 2018), February 27-March 3, 2018, Austin, Texas