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Evidence-Based Recommendations for Opioid Prescribing After Endourological and Minimally Invasive Urological Surgery
Kevin Koo1, Jared S Winoker2, Hiten D Patel3
1Department of Urology, Mayo Clinic, Rochester, Minnesota, USA.
Journal of Endourology
|June 10, 2021
Summary
Updated guidelines for postsurgical opioid use in urology reduce prescribing quantities for many procedures. Evidence supports decreased opioid recommendations, promoting better opioid stewardship for patients.
Area of Science:
- Urology
- Pain Management
- Pharmacology
Background:
- Procedure-specific guidelines are crucial for decreasing postsurgical opioid overprescribing.
- Initial recommendations for opioid use were based on limited pilot studies.
- Refining these guidelines with current evidence is essential for effective opioid stewardship.
Purpose of the Study:
- To update and refine postsurgical opioid prescribing recommendations for endourological and minimally invasive urological procedures.
- To integrate emerging clinical evidence with expert panel consensus.
- To enhance opioid stewardship strategies in urological surgery.
Main Methods:
- A multistakeholder panel with urological subspecialty expertise was convened.
- Systematic literature review of primary studies on opioid prescribing after 16 urological procedures.
- Modified Delphi technique used to revise procedure-specific recommendations and stewardship strategies.
Main Results:
- Seven relevant studies were identified and analyzed.
- Maximum recommended opioid quantities were reduced for 11 of 16 procedures.
- Opioids are no longer recommended for diagnostic endoscopy and transurethral resection procedures.
Conclusions:
- Evidence supports reduced initial opioid prescribing recommendations for most minimally invasive urological procedures.
- Shared decision-making and reevaluation of prescribing patterns are recommended for improved opioid stewardship.
- Updated guidelines can decrease overprescribing and optimize patient care.
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