Patterns of opioid use in dialysis access procedures

Area of Science:

• Nephrology
• Pain Management
• Surgical Procedures

Background:

• Overprescription of opioids post-surgery contributes to misuse.
• Dialysis access procedures are common outpatient operations lacking pain management guidelines.
• Characterizing opioid use after these procedures can inform conservative prescribing.

Purpose of the Study:

• To characterize opioid pain medication use after dialysis access surgery.
• To promote a conservative approach to postoperative opioid prescriptions.
• To reduce opioid misuse and leftover medication.

Main Methods:

• Retrospective review of patients undergoing dialysis access procedures (August 2018 - January 2019).
• Patient-reported opioid use via questionnaire and electronic medical record.
• Procedures classified by type (AVF-L, AVF-S, PD); descriptive statistics performed.

Main Results:

• 85% of patients received opioid prescriptions, but 31% used none and 71% used opioids for ≤2 days.
• Over 50% reported receiving more medication than used, with a median of 8 excess pills.
• Prescribed oxycodone or repeated operations correlated with increased opioid use.

Conclusions:

• Most patients use few opioid pills post-dialysis access surgery, indicating overprescription.
• Conservative prescription guidelines with lower quantities can reduce opioid risks.
• Recommended prescription quantities generated to ensure adequate analgesia and minimize waste.