Personalized Opioid Dosing Suggested Following Hysterectomy

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Patients reported using about half of the opioids prescribed, with a median excess of 110 oral morphine equivalents.
Patients reported using about half of the opioids prescribed, with a median excess of 110 oral morphine equivalents.

HealthDay News — Gynecologists prescribe about twice the amount of opioids than patients use after hysterectomy for benign, nonobstetric indications, according to a study published online in Obstetrics & Gynecology.

Sawsan As-Sanie, MD, MPH, from the University of Michigan in Ann Arbor, and colleagues quantified physician prescribing patterns and patient opioid use in the 2 weeks after hysterectomy for benign, nonobstetric indications. Patients completed the Fibromyalgia Survey before hysterectomy, and opioid use and pain scores were obtained after surgery. One hundred two patients participated (43.1% underwent laparoscopic, 41.2% vaginal, and 15.7% abdominal hysterectomies).

The researchers found that 200 oral morphine equivalents was the median amount of opioids prescribed. Patients reported using about half of the opioids prescribed, with a median excess of 110 oral morphine equivalents. Preoperative Fibromyalgia Survey score, overall body pain, preoperative opioid use, prior endometriosis, abdominal (versus laparoscopic) hysterectomy, and uterine weight were significant predictors in the best fit model of total opioid consumption. There was a correlation for highest tertile of Fibromyalgia Survey score with greater daily opioid consumption (13.9 greater oral morphine equivalents at baseline).

"A personalized approach to prescribing opioids for postoperative pain should be considered," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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Reference

As-Sanie S, Till SR, Mowers EL, et al. Opioid prescribing patterns, patient use, and postoperative pain after hysterectomy for benign indications [published online November 3, 2017]. Obstetrics & Gynecology. doi: 10.1097/AOG.0000000000002344

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