Open AccessAnalgesic and Opioid Use for Patients Discharged from the Emergency Department with Ureteral Stones
Author(s) -
Andrew C. Meltzer,
Allan B. Wolfson,
Patrick W. Mufarrij,
Cora MacPherson,
Nataly Montano,
Ziya Kırkalı,
Pamela K. Burrows,
Stephen V. Jackman
Publication year - 2021
Publication title -
journal of endourology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.121
H-Index - 92
eISSN - 1557-900X
pISSN - 0892-7790
DOI - 10.1089/end.2020.0835
Subject(s) - medicine , analgesic , renal colic , emergency department , tamsulosin , randomization , opioid , anesthesia , surgery , randomized controlled trial , alternative medicine , receptor , pathology , hyperplasia , psychiatry
Objective: The aim of this study was to describe and characterize the analgesic and opioid use for patients discharged from the emergency department (ED) with renal colic due to ureteral stone. Methods: This is a secondary analysis of a multicenter prospective trial of ED patients diagnosed by CT scan as having a symptomatic ureteral stone <9 mm in diameter. Participants were contacted after randomization on days 2, 7, 15, 20, and 29 and reported opioid and nonopioid analgesic use and stone passage. CT scan was repeated on day 29 to 36 to confirm passage. Results: Of 403 participants, 314 (77.9%) took an analgesic after discharge and 199 (49.4%) took opioids. Opioids were more commonly used by younger patients ( p = 0.04) and those with a family history of stones ( p = 0.003). Stone size and tamsulosin use were not associated with analgesic utilization. Shorter time to passage and more distal stone location were associated with less analgesic and opioid use. For those who did not expel a stone, 55.0% took opioids at any time, and for those who did expel a stone, 31.9% took opioids before the stone was expelled and 15.7% took opioids at any time after the stone was expelled. Conclusions: Factors associated with increased use of analgesics in patients discharged from the ED include a longer time to stone passage, no spontaneous passage, and proximal position of the stone in the ureter. Some patients continued to use analgesics after the stone had passed, but most stopped using analgesics by day 29. The study has been registered at https://clinicaltrials.gov (NCT00382265).