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Reducing or stopping the use of oral
opioids is safe and feasible for after surgery pain relief.
The results of a recent study published
in Surgery
for Obesity and Related Disease found that stopping
oral opioids usage for analgesia after laparoscopic Roux-en-Y gastric bypass (LRYGB) and
laparoscopic sleeve gastrectomy (SG) does not negatively affect patient care
metrics (length
of hospital stay, delta pain score, 30 day emergency department presentations,
and readmissions during 30 days) and may be advantageous for the
improvement of patient reported analgesia.
Prescription of oral opioids for analgesia after surgery ambulatory settings is a recognized risk factor for the development of chronic opioid dependence in bariatric population.
This retrospective study comprised of 189
patients who were administered oral opioids
in the immediate postsurgery setting, along with a prescription for oral
opioids at the time of discharge following SG and LRYGB . It was done to
explore if there is any measurable affect on the patient care metrics. The
second cohort of 136 patients did not receive any oral opioids (i.e. oral
opioid free cohort). The link of treatment type with clinical outcomes of
interest was assessed via multivariable linear and logistic regression
analysis.
The patients in the oral opioid free cohort received
considerably fewer morphine milligram equivalents for the period of their after
surgery hospital admission. A lower delta pain scores (on an average) were
described by these patients. Remaining patient care metrics didn’t had any
differences.
Along with pain relief, stopping oral opioid use
following bariatric surgery does not affect length of stay
and the rate of readmissions.
Surgery for Obesity and Related Disease
Feasibility study on elimination of all oral opioids following bariatric surgery
Adam J.Meyers et al.
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