Open AccessOpioids use after uro-oncologic surgeries in time of opioid crisis
Author(s) -
Bruno Turcotte,
Emma Jacques,
Sarah Tremblay,
Paul Toren,
Yves Caumartin,
Michele Lodde
Publication year - 2022
Publication title -
canadian urological association journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.477
H-Index - 38
eISSN - 1920-1214
pISSN - 1911-6470
DOI - 10.5489/cuaj.7633
Subject(s) - medicine , opioid , medical prescription , morphine , pharmacy , anesthesia , family medicine , receptor , pharmacology
Recent literature emphasizes how over-prescription and lack of guidelines contribute to wide variation in opioid prescribing practices and opioid-related harms. We conducted a prospective, observational study to evaluate opioid prescriptions among uro-oncologic patients discharged following elective in-patient surgery.Methods: Patients who underwent four surgeries were included: open retropubic radical prostatectomy, robot-assisted radical prostatectomy, laparoscopic radical nephrectomy, and laparoscopic partial nephrectomy. The primary outcome was the dose of opioids used after discharge (in oral morphine equivalents [MEq]). Secondary outcomes included: opioid requirements for 80% of the patients, management of unused opioids, opioid use three months postoperative, opioid prescription refills, and guidance about opioid disposal.Results: Sixty patients were included for analysis. Patients used a mean of 30 MEq (95% confidence interval 17.8–42.2) at home and 80% of the patients used 50 MEq or less. A mean of 40.4 MEq per patient was over-prescribed. Fifty percent of the patients kept the remaining opioids at home, with only 20.0% returning them to their pharmacy. After three months, 5.0% of the patients were using opioids at least occasionally. Three patients needed a new opioid prescription. Forty percent reported having received information regarding management of unused opioids.Conclusions: We found 60% of opioids prescribed were unused, with half of our patients keeping these unused tablets at home. Our results suggest appropriate opioid prescription amounts needed for urological cancer surgery, with 80% of the patients using 50 MEq or less of morphine equivalents.