I thought this was something we should know so we can share with our surgeons.
Findings from an analysis that included more than 200,000 patients who underwent common surgical procedures suggests that the optimal length of opioid pain prescriptions is 4 to 9 days for general surgery procedures, 4 to 13 days for women’s health procedures, and 6 to 15 days for musculoskeletal procedures
“While 7 days may be more than adequate for many patients undergoing common general surgery and gynaecological procedures, prescription length limits may need to be extended to 10 days, recognising that as many as 40% of patients may still require a refill at a 7-day limit for pain management, particularly following many orthopaedic and neurosurgical procedures,” said Rebecca Scully, MD, Brigham and Women’s Hospital, Boston, Massachusetts.
The researchers used the Department of Defense Military Health System Data Repository to identify individuals who had undergone 1 of 8 common surgical procedures between January 2005 and September 2014 and had not previously used opioids.
Of the 215,140 individuals who underwent a procedure within the study time frame and received and filled at least 1 prescription for opioid pain medication within 14 days of their procedure, 19% received at least 1 refill prescription.
The median prescription lengths were 4 days for appendectomy and gallbladder removal, 5 days for inguinal hernia repair, 4 days for hysterectomy, 5 days for mastectomy, 5 days for anterior cruciate ligament repair and rotator cuff repair, and 7 days for discectomy.
The early nadir in the probability of refill was at an initial prescription of 9 days for general surgery procedures (probability of refill, 10.7%), 13 days for women’s health procedures (probability of refill, 16.8%), and 15 days for musculoskeletal procedures (probability of refill, 32.5%).
“We recognise that the opiate crisis is being addressed on many social, legislative, and policy levels,” said senior author Louis Nguyen, MD, Brigham and Women’s Hospital. “We hope our paper provides a quantitative analysis of current prescribing patterns and sheds light on the optimal prescription in patients undergoing surgical procedures.”
Reference: DOI: 10.1001/jamasurg.2017.3132