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Opioid Consumption Patterns After Lumbar Microdiscectomy or Decompression.

Francis Lovecchio1, Ajay Premkumar1, Jeffrey G Stepan1

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Most patients undergoing lumbar decompression or microdiscectomy used fewer than 32 opioid pills post-surgery. These findings can inform evidence-based opioid prescribing guidelines for lumbar surgery patients.

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Area of Science:

  • Neurosurgery
  • Pain Management
  • Pharmacology

Background:

  • Opioid prescribing guidelines aim to reduce misuse and diversion.
  • Quantitative data on minimum necessary post-discharge opioid prescriptions are lacking.

Purpose of the Study:

  • To record daily opioid use and pain levels after one-level lumbar decompression or microdiscectomy.
  • To establish benchmarks for opioid consumption in post-operative patients.

Main Methods:

  • Prospective observational study of 85 adult patients undergoing lumbar decompression or microdiscectomy.
  • Automated text-messaging platform used to collect daily opioid consumption and pain scores for 6 weeks.
  • Opioid use converted to oral morphine equivalents (OME) and oxycodone 5mg equivalents.

Main Results:

  • Median opioid consumption was 32 pills (236.3 OME); 75% consumed ≤57 pills (431.3 OME).
  • Pain scores declined steadily, with half of patients ceasing opioids by postoperative day 7.
  • Only 22.4% finished their initial prescription, and 9.4% obtained a refill.

Conclusions:

  • Data can inform evidence-based opioid prescription guidelines.
  • Establish benchmarks for opioid use after lumbar decompression or microdiscectomy.
  • Identify patients with higher opioid consumption patterns.