An analysis of analgesia and opioid prescribing for veterans after thoracic surgery

Abstract The opioid crisis is a public health issue and has been linked to physician overprescribing. Pain management after thoracic surgery is not standardized at many centers, and we hypothesized that excessive narcotics were being dispensed on discharge. As a quality improvement initiative, we so...

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Autores principales:	Matthew J. Pommerening, Aaron Landau, Katherine Hrebinko, James D. Luketich, Rajeev Dhupar
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f6eb55498ad24c2481c18c1113e7ef71
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spelling	oai:doaj.org-article:f6eb55498ad24c2481c18c1113e7ef712021-12-02T16:24:49ZAn analysis of analgesia and opioid prescribing for veterans after thoracic surgery10.1038/s41598-020-68303-92045-2322https://doaj.org/article/f6eb55498ad24c2481c18c1113e7ef712020-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-020-68303-9https://doaj.org/toc/2045-2322Abstract The opioid crisis is a public health issue and has been linked to physician overprescribing. Pain management after thoracic surgery is not standardized at many centers, and we hypothesized that excessive narcotics were being dispensed on discharge. As a quality improvement initiative, we sought to understand current prescribing practices to better align the amount of opioids dispensed on discharge to actual patient needs. This was a single-center, retrospective review of patients undergoing thoracic surgery from 7/2015 to 7/2018. Demographics, operative data, perioperative pain medication use, and discharge pain medication prescriptions were analyzed. Opioids were converted to Morphine Milligram Equivalents (MME). Among 124 patients, 103 (83%) received intraoperative nerve blocks and 106 (85.5%) used PCAs. Prescribed MME/day at discharge were significantly higher than MME/day received during hospitalization (Median 30 [IQR 30–45] vs. 15 [IQR 5–24], p < 0.001) and were not associated with receiving a nerve block or PCA. By procedure, prescribed MME/day were significantly higher than inpatient MME/day for wedge resections (p < 0.001), segmentectomies (p = 0.02), lobectomies (p = 0.003), and thymectomies (p = 0.02). Patients are being discharged with significantly more opioids than they are using as inpatients. Education among prescribers and a standardized approach with patient-specific dosing may reduce excessive opioid dispensing.Matthew J. PommereningAaron LandauKatherine HrebinkoJames D. LuketichRajeev DhuparNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 10, Iss 1, Pp 1-5 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Matthew J. Pommerening Aaron Landau Katherine Hrebinko James D. Luketich Rajeev Dhupar An analysis of analgesia and opioid prescribing for veterans after thoracic surgery
description	Abstract The opioid crisis is a public health issue and has been linked to physician overprescribing. Pain management after thoracic surgery is not standardized at many centers, and we hypothesized that excessive narcotics were being dispensed on discharge. As a quality improvement initiative, we sought to understand current prescribing practices to better align the amount of opioids dispensed on discharge to actual patient needs. This was a single-center, retrospective review of patients undergoing thoracic surgery from 7/2015 to 7/2018. Demographics, operative data, perioperative pain medication use, and discharge pain medication prescriptions were analyzed. Opioids were converted to Morphine Milligram Equivalents (MME). Among 124 patients, 103 (83%) received intraoperative nerve blocks and 106 (85.5%) used PCAs. Prescribed MME/day at discharge were significantly higher than MME/day received during hospitalization (Median 30 [IQR 30–45] vs. 15 [IQR 5–24], p < 0.001) and were not associated with receiving a nerve block or PCA. By procedure, prescribed MME/day were significantly higher than inpatient MME/day for wedge resections (p < 0.001), segmentectomies (p = 0.02), lobectomies (p = 0.003), and thymectomies (p = 0.02). Patients are being discharged with significantly more opioids than they are using as inpatients. Education among prescribers and a standardized approach with patient-specific dosing may reduce excessive opioid dispensing.
format	article
author	Matthew J. Pommerening Aaron Landau Katherine Hrebinko James D. Luketich Rajeev Dhupar
author_facet	Matthew J. Pommerening Aaron Landau Katherine Hrebinko James D. Luketich Rajeev Dhupar
author_sort	Matthew J. Pommerening
title	An analysis of analgesia and opioid prescribing for veterans after thoracic surgery
title_short	An analysis of analgesia and opioid prescribing for veterans after thoracic surgery
title_full	An analysis of analgesia and opioid prescribing for veterans after thoracic surgery
title_fullStr	An analysis of analgesia and opioid prescribing for veterans after thoracic surgery
title_full_unstemmed	An analysis of analgesia and opioid prescribing for veterans after thoracic surgery
title_sort	analysis of analgesia and opioid prescribing for veterans after thoracic surgery
publisher	Nature Portfolio
publishDate	2020
url	https://doaj.org/article/f6eb55498ad24c2481c18c1113e7ef71
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An analysis of analgesia and opioid prescribing for veterans after thoracic surgery

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