Opioid-Free Discharge Feasible After Pancreatectomy
Medically reviewed by Drugs.com.
By Elana Gotkine HealthDay Reporter
THURSDAY, Sept. 7, 2023 -- Opioid-free discharge is feasible after pancreatic surgery, according to a study published online Sept. 6 in JAMA Surgery.
Artem Boyev, D.O., from The University of Texas MD Anderson Cancer Center in Houston, and colleagues analyzed the outcomes of two iterative risk-stratified pancreatectomy clinical pathway updates in a cohort study including 832 adult patients who underwent pancreatic resection. The patients comprised three sequential pathway cohorts: Version (V)1 of the pathway established a baseline and reduced length of stay; V2 updated education handouts, limited intravenous opioids, suggested a nonopioid bundle, and implemented the 5x multiplier to calculate discharge volume; and V3 required the nonopioid bundle as default in the recovery room (363, 229, and 240 patients, respectively).
The researchers found that from V1 to V3, there was an increase in early nonopioid bundle administration. A decrease was seen in total inpatient oral morphine equivalents (OME) from V1 to V2 to V3 (median of 290 to 184 to 129 mg, respectively). From V1 to V2 and V3, the discharge OME decreased from a median of 150 to 25 to 0 mg, respectively. There was an increase in the percentage of patients discharged opioid-free from 7.2 to 52.5 percent from V1 to V3; in V3, 77.9 percent were discharged with 50 mg OME or less. In all cohorts, the median pain scores remained 3 or lower, with no differences in postdischarge refill requests.
"Our enhanced recovery program, which includes generalizable protocols to reduce reliance on opioid medications, is the first to demonstrate continuous decreases in opioid use and distribution after pancreatic surgery," coauthor Ching-Wei D. Tzeng, M.D., also from The University of Texas MD Anderson Cancer Center, said in a statement.
One author disclosed ties to PanTher.
Abstract/Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.
© 2024 HealthDay. All rights reserved.
Posted September 2023
Read this next
Perioperative Chemo Improves Progression-Free Survival in Pancreatic Cancer
TUESDAY, July 2, 2024 -- For patients with resectable pancreatic ductal adenocarcinoma (PDAC), the 12-month progression-free survival (PFS) may be increased with neoadjuvant...
Few Patients With Positive Margins After Basal Cell Excision Have Recurrence
MONDAY, July 1, 2024 -- Among patients with incompletely excised basal cell carcinoma (BCC), only about 16 percent with positive histopathologic margins have clinical recurrence...
Pediatric Surgical Opioid Prescribing Concentrated Among a Few Procedures
WEDNESDAY, June 26, 2024 -- Pediatric surgical opioid prescribing is concentrated among a small number of procedures, especially tonsillectomy and/or adenectomy, according to a...
More news resources
- FDA Medwatch Drug Alerts
- Daily MedNews
- News for Health Professionals
- New Drug Approvals
- New Drug Applications
- Drug Shortages
- Clinical Trial Results
- Generic Drug Approvals
Subscribe to our newsletter
Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.