Postoperative opioid prescribing patterns and use after vascular surgery.

Area of Science:

• Vascular Surgery
• Pain Management
• Pharmacology

Background:

• Postoperative opioid prescribing patterns after vascular surgery are not well-defined.
• Variability in prescribing may lead to suboptimal pain control and potential for misuse.

Purpose of the Study:

• To assess opioid prescribing, usage, and pain control after common vascular surgeries.
• To develop patient-centered best-practice guidelines for postoperative opioid prescribing.

Main Methods:

• Prospective review of opioid prescribing and patient questionnaires (n=110).
• Retrospective analysis of opioid prescribing patterns (n=939) normalized to morphine milligram equivalents (MME).
• Survey of prescribers regarding attitudes and practices.

Main Results:

• Opioids prescribed for 78% of procedures; 70% of patients used them.
• Median opioid use was 30% of the amount prescribed (range 14-64%).
• Patients perceived opioids as appropriate (59%), insufficient (16%), or overprescribed (25%); pain control was generally good.

Conclusions:

• Significant variability exists in postoperative opioid prescribing for vascular surgery.
• Opioid utilization is substantially lower than prescribed amounts.
• Developed guidelines to optimize opioid prescribing practices for vascular surgery patients.