Are opioids being over-prescribed in gynaecology surgery?

Abstract

Although opioids are highly effective in managing post-operative pain, patients undergoing surgical procedures are at risk of developing a new persistent opioid. Concerns regarding the volume of patients on long-term opioids in our region prompted a service evaluation to review take-home post-operative opioid prescriptions in gynaecology surgical patients. Results showed an average duration of opioid prescription of 7.9 days and longer durations of take-home opioid prescriptions in the laparoscopy group compared to the laparotomy group (8.6 vs 7.1 days), despite lower inpatient opioid consumption in these groups (10.2 mg vs 17.0 mg morphine equivalent daily dose). Previous studies have quantified patients' post-operative opioid consumption and demonstrated effective use of restrictive opioid regimes. The unit described is prescribing more than has been demonstrated to be consumed and therefore required. As the duration of opioid use is recognised as the strongest predictor of future opioid misuse, an opioid duration limit of 3 days is suggested.