Researchers at The University of Texas MD Anderson Cancer Center have successfully reduced inpatient opioid use by 50% after pancreatic cancer surgery, according to a study published in JAMA Surgery.
The study also showed that the median opioid prescription volume at discharge dropped to zero, potentially minimizing the risk of long-term opioid dependence among patients.
The cohort study involved 832 patients undergoing pancreatic resection surgery from 2018 to 2022.
The researchers focused on how incremental changes to post-surgery protocols could affect the amount of opioids used by patients both during their hospital stay and upon discharge.
In less than four years, total inpatient oral morphine equivalents (OME) decreased from a median of 290 mg to 129 mg.
OME at discharge dropped from a median of 150 mg to zero.
Over 75% of patients were discharged with ≤ 50 mg OME, equating to fewer than 10 pills.
The study shows that the use of nerve block procedures, non-opioid medications like muscle relaxers and anti-inflammatories, and early patient mobilization can effectively manage pain without the risk of opioid dependence.
The Importance
Pancreatic cancer surgery is highly complex and painful, making it a candidate for post-operative opioid prescriptions. However, excess opioid use can lead to dependency issues and community misuse.
“By making purposeful, successive improvements to existing processes, we showed that we can reduce the amount of opioids patients need after a major surgery while ensuring they recover well without any extra costs,” said Dr. Ching-Wei Tzeng, the study’s senior author.
Future Implications
The findings indicate that alternative pain management strategies can be effectively implemented without incurring additional costs.
This could set a new standard for post-operative care, potentially reducing the risk of long-term opioid dependence and contributing to tackling the opioid crisis.
Building on the promising results, the researchers aim to continue fine-tuning and potentially expanding the protocols to other surgical procedures and settings.
Further studies could focus on long-term patient outcomes and the generalizability of these approaches to different types of surgeries and hospitals.
The study suggests that with careful planning and execution, it is possible to manage post-surgical pain effectively while reducing the reliance on opioids, which is a major win in the fight against the opioid epidemic.
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The research findings can be found in JAMA Surgery.
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