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Postoperative opioid prescribing after lower extremity bypass surgery often results in significant oversupply. Patients consumed only 37% of prescribed opioid pills, highlighting a substantial risk for misuse and diversion.

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Area of Science:

  • Vascular Surgery
  • Pain Management
  • Public Health

Background:

  • Opioid overprescription contributes to the opioid epidemic through diversion and misuse.
  • Evidence-based prescribing guidelines are advocated by the surgical community.
  • Acute postoperative pain management requires careful consideration of opioid use.

Purpose of the Study:

  • To evaluate patient-reported opioid consumption after lower extremity bypass surgery.
  • To identify the discrepancy between prescribed and consumed opioids in this patient population.
  • To inform practice recommendations for opioid prescribing in vascular surgery.

Main Methods:

  • Retrospective review of infrainguinal bypass operations (2016-2019).
  • Telephone survey assessing percentage of opioid pills used at discharge.
  • Exclusion of patients with chronic opioid use or reoperations/amputations within 30 days.

Main Results:

  • 41 out of 49 patients (84%) were prescribed opioids; 27 (65.9%) completed the survey.
  • Average prescribed opioid dose: 318 ± 156 morphine milligram equivalents.
  • Only 37% of 940 prescribed opioid pills were consumed, leaving 568 unused pills.

Conclusions:

  • This study is the first to assess opioid use specifically in lower extremity bypass patients.
  • Over 60% of prescribed opioid pills were unused, posing a significant risk for misuse.
  • Findings support the need to reduce opioid overprescription in vascular surgery to mitigate societal risks.