Optimal Pain Control after Outpatient Surgery for Cutaneous Malignancies
| Autor: | James M. McLoughlin, Robert E. Heidel, James M. Lewis, Rachel Lewis, Andrew Joseph Ward, Bethany R Sappington |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Bupivacaine
medicine.medical_specialty Local anesthetic medicine.drug_class Narcotic business.industry medicine.medical_treatment Outpatient surgery Chronic pain Retrospective cohort study General Medicine medicine.disease 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Opioid Internal medicine medicine 030212 general & internal medicine Skin cancer business medicine.drug |
| Zdroj: | Web of Science |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481908500935 |
| Popis: | Postoperative pain managed with opioids has contributed to the opioid crisis through over-prescribing practices. We assessed opioid-prescribing habits and their use by patients undergoing surgery for cutaneous malignancies. An Institutional Review Board–approved retrospective analysis was conducted for patients who underwent skin cancer resection between January 2018 and June 2018. Data were collected from the electronic medical record, and opioid-related data were collected from patient interviews and state registries. There were 120 study participants (42 females and 78 males) with a median age of 67 years (range, 21–94 years). All received preincision local anesthetic: 64 had liposomal bupivacaine (LB) (53%) and 56 had non-LB bupivacaine (47%). Most participants (n = 88) used 0 opioids (73%), including 43 LB-anesthetic (67%) and 45 non–LB-anesthetic (80%). No significance was seen between those with a diagnosis of chronic pain, narcotic tolerance, an area of resection, and nodal sampling groups in opioid use. Four patients (3%) requested a refill. Of 105 prescriptions written for opioids, 99 had leftover opioids for an over-prescribing rate of 94 per cent. This study suggests pain after skin cancer surgery is manageable with very limited opioid requirements. Our results support prescribing no more than five opioid tablets for postoperative pain control in patients undergoing resection for skin malignancies. |
| Databáze: | OpenAIRE |
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