Perception versus Reality: A Review of Narcotic Prescribing Habits After Common Laparoscopic Surgeries

• Published in: The Journal of surgical research 2023-03, Vol.283, p.188-193
• Main Authors: Walk, Casey T., Nowak, Rebecca, Parikh, Priti P., Crawford, Timothy N., Woods, Randy J.
• Format: Article
• Language: English
• Subjects: Analgesics, Opioid; Habits; Humans; Laparoscopy; Morphine; Narcotic prescribing education; Narcotic prescription; Narcotics; Opioid prescription; Pain, Postoperative; Perception; Practice Patterns, Physicians
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2022.10.049

Data on how surgeons perceive their habits of prescribing narcotics compared to their actual practice are scarce. This study examines the perception and actual narcotic prescribing habits of surgeons and advanced practitioners. Surgical residents, attendings, and advanced practice providers (APPs) were surveyed to assess their perceived prescribing habits at discharge for laparoscopic appendectomy and laparoscopic cholecystectomy. Data on narcotics prescription for patients receiving either of the procedures from January 2017 to August 2020 were extracted from electronic health records. Prescribed narcotics were converted to morphine equivalent doses (MEQs) for comparison. Of the 52 participants, the majority were residents (57.7%). Approximately 90% of residents, 72% of attendings, and 18% of APPs reported regularly prescribing narcotics at discharge. Approximately 67% (889/1332) of patients were discharged with narcotics. Of those, the majority of patients’ narcotics were prescribed by surgery residents (71.2%). However, 72% of residents, 80% of attendings, and 72% of APPs were confident on prescribing the correct regimen of narcotics. There were no differences in average daily MEQs among the groups. However, the number of narcotics prescribed was higher among APPs compared to that in the other groups (P