Most significant was the prescribing patterns. Patients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively.
We know that overprescribing increases the risk of opioid misuse and abuse, so it's really imperative that we as surgeons recognize our role in helping to fix this problem.
Best of the Best Gen Surg - Predictors of Low and High Opioid Tablet Consumption after Inguinal Hernia Repair – an ACHQC Opioid Reduction Task Force Analysis - Dr. Warren
▶Ep 13 · 0:21
quoteI first want to thank Drs. Rosen and Ponsky for putting together this session and allowing me to participate.↗
▶Ep 13 · 1:30
host_summaryOver half a million opioid-related deaths occurred in the last 20 years↗
▶Ep 13 · 1:40
host_summaryPrescription opioid-related deaths increased by 17% in the last year↗
▶Ep 13 · 1:50
quoteit's really critical for us to understand that the transition to synthetic opioids and heroin often begins with exposure to prescribed opioids.↗
▶Ep 13 · 1:50
host_summaryTransition to synthetic opioids and heroin often begins with exposure to prescribed opioids↗
▶Ep 13 · 2:05
host_summaryA 2017 Dartmouth study demonstrated wide range of surgeon prescribing patterns for common procedures and that patients typically consume dramatically less opioid than prescribed↗
▶Ep 13 · 2:35
host_summaryPatients were prescribed between 15 and 120 opioid tablets after inguinal hernia repair, with an average of over 30 pills prescribed↗
▶Ep 13 · 2:55
host_summaryPatients reported taking only 15 to 30 percent of prescribed tablets after inguinal hernia repair↗
▶Ep 13 · 3:10
epidemiologicalMore than 60 percent of inguinal hernia patients in a Greenville study required no opioid consumption↗
▶Ep 13 · 3:20
quoteWe know that overprescribing increases the risk of opioid misuse and abuse, so it's really imperative that we as surgeons recognize our role in helping to fix this problem.↗
▶Ep 13 · 3:40
clinicalThe ACHQC is a national hernia-specific registry containing over 100,000 patients↗
▶Ep 13 · 4:20
epidemiologicalOver 80 percent of patients reported taking less than 10 pills after inguinal hernia repair↗
▶Ep 13 · 4:30
epidemiologicalOver 50 percent of patients reported taking no opioids at all after inguinal hernia repair↗
▶Ep 13 · 4:40
clinicalYounger age, smokers, ASA 3 or 4, preoperative opioid use, open mesh repairs, longer operative times, and worse baseline quality of life increased the risk of high opioid consumption post-op↗
▶Ep 13 · 4:45
clinicalThe study analyzed 1,937 patients undergoing elective, clean inguinal hernia repair with completed 30-day follow-up and complete opioid data↗
▶Ep 13 · 5:00
clinicalPatients were at significantly higher risk of opioid consumption when prescribed a higher volume of pills↗
▶Ep 13 · 5:00
epidemiological59 percent of cases were minimally invasive inguinal hernia repairs (lap and robotic), 35 percent open mesh repairs, and 6 percent open tissue repairs↗
▶Ep 13 · 5:10
clinicalHistory of smoking increases the risk of opioid consumption after inguinal hernia repair↗
▶Ep 13 · 5:15
epidemiologicalPatients reported consuming zero narcotics in 50 percent of cases, with only 8 percent reporting more than 10 tablets consumed↗
▶Ep 13 · 5:20
clinicalPatients with prior or recent opioid use are at higher risk of post-operative opioid consumption, supporting avoidance of prescribing opioids for hernia-related pain prior to surgery↗
▶Ep 13 · 5:30
clinicalOlder age, ASA 1 or 2, use of local anesthetic, use of sedation versus general anesthetic, and shorter operative time all increased the chances that patients would use zero narcotics post-op↗
▶Ep 13 · 5:35
clinicalMinimally invasive approach and use of local anesthetic are surgeon-modifiable factors that reduce opioid consumption↗
▶Ep 13 · 5:40
quoteWe can see empirically that patients just do not need a just-in-case medication and that this in fact increases their risk of higher consumption.↗
▶Ep 13 · 5:45
clinicalPatient-reported opioid use is significantly impacted by surgeon prescribing↗
▶Ep 13 · 5:45
quoteMost significant was the prescribing patterns. Patients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively.↗
▶Ep 13 · 5:50
clinicalPatients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively↗
