Pre-Operative Assessment Tool To Predict Post-operative Pain and Opioid Use in Outpatient Urologic Surgery

To better understand the pain requirements of urologic patients in the post-operative outpatient setting. Healthcare providers are one of the leading contributors to the current opioid epidemic. Understanding opioid prescribing practices and patients’ narcotic requirements while not over-prescribing...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2022-03, Vol.161, p.19-24
Main Authors: Butler, Christi, Mmonu, Nnenaya, Cohen, Andrew J., Rios, Natalie, Huang, Chiung-Yu, Breyer, Benjamin N.
Format: Article
Language:English
Subjects:
Adult
Ambulatory Surgical Procedures - adverse effects
Analgesics, Opioid - therapeutic use
Female
Humans
Opioid-Related Disorders - diagnosis
Opioid-Related Disorders - epidemiology
Opioid-Related Disorders - prevention & control
Outpatients
Pain, Postoperative - diagnosis
Pain, Postoperative - drug therapy
Practice Patterns, Physicians
Prospective Studies
Urology
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Summary:To better understand the pain requirements of urologic patients in the post-operative outpatient setting. Healthcare providers are one of the leading contributors to the current opioid epidemic. Understanding opioid prescribing practices and patients’ narcotic requirements while not over-prescribing opioids is a public health priority. We conducted a prospective study to examine opioid consumption among adult patients who presented for outpatient urologic surgery at the University of California San Francisco (UCSF) and Zuckerberg San Francisco General (ZSFG) hospitals. We administered a Pre-Operative Pain Requirement Assessment Tool (POPRAT) electronically via text message 3 days prior to surgery to identify objective factors that may predict post-operative pain and opioid requirements. Patients were followed for 7 days post-operatively, in a similar fashion, to assess daily pain, and opioid use. Two hundred and sixty-four participants were eligible for the study and 211 completed the study. Urology patients undergoing outpatient elective procedures used a mean of 5 morphine milligram equivalents (MME) (SD = 14.9) in a 7-day period. Women and patients less than 45 years of age had the highest opioid use. Based on the POPRAT, major predictors of post-operative pain were pre-operative anxiety (0.34 estimate, P value
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2021.12.002