Urology resident, PYG-3
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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||Unmoderated Posters||Association between patients' and urologists' perspectives with telemedicine||TBD|