UP-42 Opioids use after uro-oncologic surgeries in time of opioids crisis, the Quebec experience
Thursday June 27, 2019 from
TBD
Award Winner
Bruno Turcotte, Canada has been granted the
Presenter

Bruno Turcotte, Canada

Urology resident, PYG-3

Urology

Université Laval

Abstract

Opioids use after uro-oncologic surgeries in time of opioids crisis, the Quebec experience

Bruno Turcotte1, Michele Lodde1, Yves Caumartin1, Emma Jacques1.

1Urology, CHU de Québec - Université Laval, Québec, QC, Canada

Introduction: Opioid overdose and addiction are two contemporary growing problems. As health providers, we have an important role in this problem. Recent literature emphasizes overprescription and its link to opioid-related harms. We conducted a prospective observational study to find how much opioids uro-oncologic patients really need after surgery in our regional and tertiary center.

Methods: This monocentric study included 4 oncologic uncomplicated surgeries: open retropubic radical prostatectomy, robot-assisted laparoscopic radical prostatectomy, laparoscopic radical nephrectomy, and laparoscopic partial nephrectomy. The primary outcome was the dose of opioid consumed (in oral morphine-equivalent (MEq)) and secondary outcomes included the amount of overprescribed opioids, the amount of opioid requirement for 80% of patients, management of unused opioids, and others. Patients were invited to fill three home questionnaires at 0, 1 et 3 months post-operative.

Results: Between October 2019 and August 2020, 60 patients were recruited and included for analysis. Patients used a mean of 30 MEq (6 tablets) at home and 80% of patients used 50 MEq (10 tablets) or less. There was no significant difference in opioid consumption between different surgeries in our study (p = 0.68). Patients who consumed less than 27.5 MEq during hospitalization were 4.46 times more prone to consume no opioid at home (p = 0.01). A total of 2220 MEq was overprescribed (the equivalent of 444 morphine 5 mg tablets) in only 55 responders. 50% of the patients or more kept the remaining opioids at home and only 13% of them returned the remaining opioids to their pharmacy.

Conclusion: This study emphasizes the importance of prescribing opioids wisely as too many tablets are still being prescribed. We should encourage a diminution in total MEq after uro-oncologic surgeries and we could probably decrease it more with optimization of co-analgesia which was not optimized in this observational study.


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