The optimal duration of postsurgical opioid prescriptions likely ranges from 4 to 15 days, depending on the procedure, a JAMA Surgery study suggests.
Using a U.S. military health system database, researchers identified 215,000 opioid-naive adults up to age 64 who underwent one of eight common surgeries and filled an opioid prescription within 14 days after the procedure.
The median duration of the initial opioid prescription ranged from 4 to 7 days, depending on the surgery type. Overall, nearly 20% of patients refilled the prescription. The probability of refilling it was lowest when the initial prescription was:
- 9 days for general surgical procedures (appendectomy, cholecystectomy, inguinal hernia repair)
- 13 days for women’s health procedures (mastectomy, hysterectomy)
- 15 days for musculoskeletal procedures (rotator cuff repair, anterior cruciate ligament repair, discectomy)
The authors conclude that the optimal prescription duration falls between the median initial prescription length and the prescription length associated with the lowest probability of refill — that is, 4–9 days for general surgeries, 4–13 days for women’s health procedures, and 6–15 days for musculoskeletal surgeries.
A commentator advocates “setting expectations in the interpretation of pain.” He suggests using acetaminophen or ibuprofen first, and then other options if pain is not relieved. He also advises educating patients that “complete relief of all pain is impossible.”