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Examining current patterns of opioid prescribing and use after bariatric surgery. Surg Endosc 2022 Apr;36(4):2564-2569

Date

05/13/2021

Pubmed ID

33978853

DOI

10.1007/s00464-021-08544-5

Scopus ID

2-s2.0-85105861939 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

BACKGROUND: Evidence-based guidelines on the appropriate amount of opioid medications to prescribe following bariatric surgery are lacking. We sought to determine our current opioid-prescribing practices, patient utilization, and satisfaction with pain control following elective bariatric surgery.

METHODS: A retrospective chart review and phone survey were conducted on patients who underwent laparoscopic or robotic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) from April 2018 to March 2019 at a single academic medical center. Opioid medications were converted to morphine milligram equivalents provided (MMEs).

RESULTS: In total, 192 patients met inclusion criteria. The median amount of opioid medication prescribed on discharge was 300 oral MMEs, although there was a significant difference between the MMEs prescribed to patients with and without chronic opioid therapy (median 300 MMEs opioid naïve vs. 375 MMEs chronic opioid therapy, p = 0.01). Significantly fewer SG patients required a refill of their opioid medication compared to RYGB (8.3% vs. 23.9%, p = 0.003). Of the 192 patients, 87 (45.3%) completed the phone survey. Fifty-six patients (64%) reported that they took half or less of the initially prescribed opioids. Of the patients with leftover medication, 36% reported that they did not dispose of the medication. Overall understanding of pain control options after surgery was significantly lower in patients who felt they were prescribed "too little" opioids (p = 0.01), patients requiring refills (p = 0.02), and patients who were not satisfied with their pain control (p = 0.02).

CONCLUSION: There is a gap between the amount of opioid medication prescribed and taken by patients following bariatric surgery in our practice. Patients who were least satisfied with their pain control reported knowledge gaps about pain control options that were more significant than patients who were more satisfied. Future initiatives should focus on the reduction of opioids prescribed to bariatric surgery patients post-operatively and on opioid education for patients.

Author List

Ford J, Kindel T, Higgins RM, Lak KL, Hetzel E, Gould JC

Authors

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Rana Higgins MD Associate Professor in the Surgery department at Medical College of Wisconsin
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Kathleen L. Lak MD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Analgesics, Opioid
Bariatric Surgery
Humans
Pain, Postoperative
Practice Patterns, Physicians'
Retrospective Studies