Department of Surgery, University of Michigan, VA Ann Arbor Healthcare System 2210 Taubman Center, SPC 5343, Ann Arbor, MI, USA.
Department of Surgery, University of Washington, Seattle, WA, USA.
Obes Surg. 2020 Mar;30(3):1032-1037. doi: 10.1007/s11695-019-04301-9.
Opioid use after bariatric surgery is not clearly understood. Few guidelines exist to inform opioid-prescribing practices after bariatric surgery.
To understand opioid use following bariatric surgery.
University hospital.
Bariatric surgery patients at a single center were prospectively surveyed at the time of their post-operative visit (January-May 2018). Patients were asked about their opioid use following surgery, whether they received education about opioid use and what they did with leftover medications. Demographic and operative details were obtained from the medical record.
Among 33 patients, the majority (n = 29, 88%) were female with a median age of 40 (20-68) and body mass index of 44.8 (33-78.5). Most patients had leftover narcotics (n = 25, 73%). The median number of pills used was 15 (0-48). Only 12 patients (36%) thought that they had been prescribed "too much" pain medication. Most patients reported receiving education about expectations for post-operative pain (n = 22, 69%); few recalled education about reducing or stopping opioids (n = 13, 40%). More than half of patients (n = 17, 53%) kept their leftover opioids rather than disposing of them or bringing them to an approved turn in location.
Despite most patients having leftover opioids following surgery, few patients recognized possible overprescription. Education regarding opioid use following surgery is inconsistent, potentially contributing to the amount of retained opioids currently available. Future guidelines should focus on determining the appropriate amount of opioids to be prescribed following surgery and standardizing and improving education given to patients.
减重手术后的阿片类药物使用情况尚不清楚。几乎没有指导方针可以告知减重手术后的阿片类药物处方实践。
了解减重手术后的阿片类药物使用情况。
大学医院。
在单中心，对接受减重手术的患者在术后就诊时进行前瞻性调查（2018 年 1 月至 5 月）。患者被问及术后的阿片类药物使用情况、是否接受过阿片类药物使用教育以及如何处理剩余药物。从病历中获得人口统计学和手术细节。
在 33 名患者中，大多数（n=29，88%）为女性，中位年龄为 40（20-68）岁，体重指数为 44.8（33-78.5）。大多数患者有剩余的麻醉性镇痛药（n=25，73%）。使用的药丸中位数为 15（0-48）。只有 12 名患者（36%）认为他们被开了“太多”的止痛药。大多数患者报告接受了关于术后疼痛预期的教育（n=22，69%）；很少有人记得接受过减少或停止使用阿片类药物的教育（n=13，40%）。超过一半的患者（n=17，53%）保留了剩余的阿片类药物，而不是将其丢弃或带到指定的归还地点。
尽管大多数患者在手术后仍有剩余的阿片类药物，但很少有患者认识到可能存在过度处方的情况。关于手术后使用阿片类药物的教育不一致，这可能导致目前可用的阿片类药物的数量增加。未来的指南应侧重于确定手术后应开的适当阿片类药物剂量，并标准化和改进对患者的教育。
