PMID- 35024936
OWN - NLM
STAT- MEDLINE
DCOM- 20220718
LR  - 20221118
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 36
IP  - 8
DP  - 2022 Aug
TI  - Hospital opioid use predicts the need for discharge opioid prescriptions 
      following laparoscopic bariatric surgery.
PG  - 6312-6318
LID - 10.1007/s00464-022-09035-x [doi]
AB  - BACKGROUND: Overprescribing of opioids after surgery increases new persistent 
      opioid use and diversion contributing to the opioid epidemic. There is a paucity 
      of evidence regarding discharge opioid prescribing after bariatric surgery. 
      METHODS: We conducted a retrospective, cohort study analyzing post-operative 
      opioid use at a single institution in patients who underwent laparoscopic sleeve 
      gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LGB) from July 2019 
      thru February 2020. Multimodal analgesia was used including 5 mg oxycodone pills 
      as needed during hospitalization with five prescribed on discharge if requested 
      after discussion. Opioid use was determined from medical record review and 
      post-operative data collected from patients at a 2-week follow-up visit. The 
      Michigan Automated Prescription System (MAPS) was used as an adjunct to evaluate 
      perioperative opioid prescriptions. RESULTS: The cohort of 84 patients included 
      those having LSG (72) and LGB (12). Fifty-five patients (65%) received a 
      prescription for opioids on discharge and 91% filled their prescription. Only 44% 
      (22/50) of those filling their opioid prescription took any opioids with 24% 
      (65/275) of the total pills prescribed actually consumed. Opioid use on the 
      surgical ward had the strongest correlation with discharge opioid use 
      (rho = 0.65, CI 0.494, 0.770). The number of opioid pills taken on the surgical 
      ward was positively associated with the number of pills taken after discharge. 
      Those who took none, 1 to 3, or 4 or more opioid pills consumed 0.14 +/- 0.48, 
      0.95 +/- 1.71, and 3.14 +/- 1.86 pills after discharge (p < 0.001). No patients 
      required an additional opioid prescription within 90 days of surgery with MAPS 
      confirmation. CONCLUSION: Postoperative in-hospital opioid use following 
      laparoscopic bariatric surgery predicts opioid use after discharge. This 
      knowledge can guide patient-specific discharge opioid prescribing with the 
      potential to mitigate diversion and reduce chronic opioid use.
CI  - (c) 2022. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Diaz, Sarah E
AU  - Diaz SE
AUID- ORCID: 0000-0002-3549-6283
AD  - Department of General Surgery, Henry Ford Macomb Hospital, Clinton Township, MI, 
      USA. drsdiaz6@gmail.com.
FAU - Dandalides, Alissa M
AU  - Dandalides AM
AD  - Bariatric Surgery Center, Henry Ford Macomb Hospital, Clinton Township, MI, USA.
FAU - Carlin, Arthur M
AU  - Carlin AM
AD  - Department of Surgery, Henry Ford Health System, Detroit, MI, USA.
LA  - eng
PT  - Journal Article
DEP - 20220113
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Analgesics, Opioid/therapeutic use
MH  - *Bariatric Surgery
MH  - Cohort Studies
MH  - Hospitals
MH  - Humans
MH  - *Laparoscopy
MH  - *Opioid-Related Disorders
MH  - Pain, Postoperative/drug therapy
MH  - Patient Discharge
MH  - Practice Patterns, Physicians'
MH  - Prescriptions
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Bariatric
OT  - Laparoscopic Roux-en-Y gastric bypass
OT  - Laparoscopic sleeve gastrectomy
OT  - Opioid prescribing
OT  - Opioid reduction
EDAT- 2022/01/14 06:00
MHDA- 2022/07/19 06:00
CRDT- 2022/01/13 12:45
PHST- 2021/07/26 00:00 [received]
PHST- 2022/01/03 00:00 [accepted]
PHST- 2022/01/14 06:00 [pubmed]
PHST- 2022/07/19 06:00 [medline]
PHST- 2022/01/13 12:45 [entrez]
AID - 10.1007/s00464-022-09035-x [pii]
AID - 10.1007/s00464-022-09035-x [doi]
PST - ppublish
SO  - Surg Endosc. 2022 Aug;36(8):6312-6318. doi: 10.1007/s00464-022-09035-x. Epub 2022 
      Jan 13.