Postoperative Opioid Utilization Following Benign Gynecological Surgery [31Q

Abstract

INTRODUCTION: There is increasing concern for opioid over-prescribing patterns, with nearly quadrupling of the number of opioid prescriptions in the United States since 1999. There are no guidelines for directing the opioid prescription patterns following benign gynecological surgery. METHODS: We are conducting a prospective study assessing postoperative pain prescriptions and medication usage via telephone survey. RESULTS: Our preliminary results show that 54 patients underwent a benign gynecological surgery at the University of California San Francisco from August to September 2017. 45 (83.3%) patient's received an opioid prescription. 15 (27.8%) were hysteroscopy procedures, 31 (57.4%) laparoscopy, 5 (9.3%) laparotomy, and 3 (5.6%) categorized as others. On average 41.7 morphine milligram equivalents (MME) of opioids were prescribed following hysteroscopy, 176.0 MME following laparoscopy, 260.0 MME following laparotomy, and 83.3 MME following others. 33 (61.1%) patients completed the telephone survey. On average 25.6 MME of opioids were not utilized by postoperative day seven following hysteroscopy, 116.6 MME following laparoscopy, 298.1 MME following laparotomy, and 29.1 MME following others. 26 patients completed the telephone survey and utilized opioids. 46.2% would keep excess opioids for future use. 23.1% would dispose of excess opioids. CONCLUSION: Opioid analgesics are a major component of current gynecological postoperative pain management. On average patients receive in excess an equivalent of 15.5 tablets of 5mg oxycodone following laparoscopic surgery not utilized by postoperative day seven. A majority of patients are keeping excess opioids for utilization outside of their intended purpose. Data collection is ongoing and estimate an additional 100 patients for the completed study.