Center for Robotic Surgery, Northern Westchester Hospital/Northwell Health, Mount Kisco, New York; Division of Urology, Northern Westchester Hospital Northwell Health, Mount Kisco, New York.
Emergency Department, Northern Westchester Hospital, Mount Kisco, New York.
J Opioid Manag. 2021 May-Jun;17(3):241-249. doi: 10.5055/jom.2021.0634.
To evaluate the prescribing practices and opioid consumption in an ambulatory setting to inform the development of evidence-based guidelines.
A prospective study of adults undergoing outpatient open and laparoscopic surgeries over 3 months. One week after discharge, a telephonic interview quantified the number of opioids prescribed and consumed, degree of pain control and satisfaction, and whether additional pain medication was requested.
Community hospital ambulatory surgery center in Westchester County, New York.
This study included 304 adults undergoing a variety of procedures by surgeons from multiple specialties.
Quantify surgeons' postoperative opioid prescribing compared with patient opioid consumption.
Eighty-one percent (N = 245) responded to the survey, of which 64 percent were prescribed opioids. Males and females were equally represented with the mean age of 59.4 years. Of those prescribed opioids, 92 percent filled the prescription. The most commonly prescribed opioids reported by the patients that filled their prescription (N = 145) were oxycodone (36.5 percent), oxycodone/acetaminophen (28.9 percent), and tramadol (22.7 percent). The mean number of opioid pills prescribed was 20 and the mean consumption was 6.7 pills, resulting in an average of 13 retained pills. Only 3.8 percent of the patients prescribed opioids at discharge called their provider for additional analgesia. Despite the low opioid consumption patients reported high satisfaction (4.5 on scale of 0-5) with pain control. Only 10.4 percent reported that the surgeon recommended an over the counter (OTC) analgesic option. There was variability in the amount of opioids prescribed within each surgical category.
One week after outpatient surgery, patients consumed one-third of physician-prescribed opioids, yet they reported high pain management satisfaction. Our study will inform the development of a patient-centered interdisciplinary perioperative education program to more effectively tailor multimodal pain management in ambulatory surgical patients and collaterally reduce the number of retained opioids.
评估门诊环境中的处方实践和阿片类药物的使用情况，为制定基于证据的指南提供信息。
一项为期 3 个月的接受门诊开放和腹腔镜手术的成年人的前瞻性研究。出院后一周，通过电话访谈量化了开处的阿片类药物数量和使用量、疼痛控制和满意度的程度，以及是否要求额外的止痛药物。
纽约州威彻斯特县社区医院门诊手术中心。
这项研究包括了 304 名由多个专业的外科医生进行各种手术的成年人。
量化外科医生术后开处的阿片类药物与患者使用的阿片类药物的差异。
81%（N=245）的人回应了调查，其中 64%的人开了阿片类药物。男性和女性的比例相等，平均年龄为 59.4 岁。在开了阿片类药物的患者中，92%的人服用了处方。患者报告服用了最多的阿片类药物（N=145）为羟考酮（36.5%）、羟考酮/对乙酰氨基酚（28.9%）和曲马多（22.7%）。开处的阿片类药物平均数量为 20 片，平均使用量为 6.7 片，平均剩余 13 片。只有 3.8%的患者在出院时因需要额外的镇痛剂而致电医生。尽管患者报告的阿片类药物消耗量较低，但他们对疼痛控制的满意度很高（4.5 分，0-5 分）。只有 10.4%的患者报告外科医生建议使用非处方（OTC）止痛药。在每个手术类别中，开处的阿片类药物的数量存在差异。
在门诊手术后一周，患者使用了医生开处的三分之一的阿片类药物，但他们报告疼痛管理满意度很高。我们的研究将为制定以患者为中心的跨学科围手术期教育计划提供信息，以便更有效地为门诊手术患者制定多模式疼痛管理方案，并相应减少剩余阿片类药物的数量。
