Balceniuk Mark D, Zhao Peng, Chu Isabelle V, Negron Tianna M, Ayers Brian C, Glocker Roan J, Doyle Adam J, Stoner Michael C
Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
Ann Vasc Surg. 2020 Jan;62:114-118.e1. doi: 10.1016/j.avsg.2019.08.070. Epub 2019 Aug 30.
Opioid overdose is now the leading cause of injury-related death in the United States. Overprescription of opioids is one factor contributing to this epidemic. Previous studies demonstrated an overprescription of opioids compared with patient consumption after general surgery procedures. The objective of this study is to evaluate opioid consumption after carotid revascularization.
This is a retrospective review of the opioid-prescribing habits after discharge of carotid revascularization. Patients who were documented to receive an opioid prescription were included in the study. A phone survey was conducted to determine patient consumption of the prescribed pills. Surgical procedures include carotid endarterectomy (CEA) and transcarotid arterial revascularization (TCAR). The primary outcome is the difference between opioids prescribed and opioids consumed.
There were 209 patients available for inclusion. The mean age was 68 years with white (98%) males (58%) making up most patients. CEA and TCAR accounted for 75% and 25% of cases, respectively. About 98 (47%) patients were prescribed opioids after discharge. Eight were excluded from analysis (3 for prior opioid use and 5 declined participation). About 71% of patients participated in the survey. A total of 1,623 pills were prescribed (25.4 ± 5.5 per patient), but only 336 pills were consumed (5.3 ± 1.1 per patient). About 1,287 (79% of total) pills were not consumed.
These data are the first to compare opioid prescription with opioid consumption after carotid revascularization. We demonstrate that patients consume much less opioids than prescribed. These findings indicate that a reduction in opioid prescriptions may be possible after carotid revascularization.
阿片类药物过量目前是美国与伤害相关死亡的主要原因。阿片类药物的过度处方是导致这一流行趋势的一个因素。先前的研究表明，与普通外科手术后患者的用药量相比，存在阿片类药物过度处方的情况。本研究的目的是评估颈动脉血运重建术后的阿片类药物使用情况。
这是一项对颈动脉血运重建术后出院患者阿片类药物处方习惯的回顾性研究。记录中接受阿片类药物处方的患者被纳入研究。通过电话调查来确定患者对所开药片的使用情况。手术方式包括颈动脉内膜切除术（CEA）和经颈动脉动脉血运重建术（TCAR）。主要结局是所开阿片类药物与实际使用阿片类药物之间的差异。
有209例患者可供纳入研究。平均年龄为68岁，大多数患者为白人（98%）男性（58%）。CEA和TCAR分别占病例的75%和25%。约98例（47%）患者出院后被开了阿片类药物。8例被排除在分析之外（3例因先前使用过阿片类药物，5例拒绝参与）。约71%的患者参与了调查。总共开了1623片药（每位患者25.4±5.5片），但仅服用了336片（每位患者5.3±1.1片）。约1287片（占总数的79%）未被服用。
这些数据首次比较了颈动脉血运重建术后阿片类药物的处方量与使用量。我们证明患者服用的阿片类药物比所开的少得多。这些发现表明，颈动脉血运重建术后减少阿片类药物处方量是有可能的。
