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Variability in Opioid Prescription Following Primary Single-Level Lumbar Microdiscectomy
STUDY DESIGN: Retrospective case series. OBJECTIVES: To evaluate the variability in opioid prescription following primary single-level lumbar microdiscectomy. METHODS: We retrospectively reviewed consecutive patients who underwent primary single-level lumbar microdiscectomy. Only opioid-naïve patien...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907642/ https://www.ncbi.nlm.nih.gov/pubmed/32856480 http://dx.doi.org/10.1177/2192568220950678 |
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author | Le, Hai Phan, Eileen Agatstein, Lauren Barber, Joshua Klineberg, Eric Roberto, Rolando Javidan, Yashar |
author_facet | Le, Hai Phan, Eileen Agatstein, Lauren Barber, Joshua Klineberg, Eric Roberto, Rolando Javidan, Yashar |
author_sort | Le, Hai |
collection | PubMed |
description | STUDY DESIGN: Retrospective case series. OBJECTIVES: To evaluate the variability in opioid prescription following primary single-level lumbar microdiscectomy. METHODS: We retrospectively reviewed consecutive patients who underwent primary single-level lumbar microdiscectomy. Only opioid-naïve patients ≥18 years old were included. Patients who had revision microdiscectomy, multilevel decompression, and/or any complication requiring prolonged hospital stay (>2 days) were excluded. The primary outcomes were the maximum daily dosage of opioids prescribed in morphine milligram equivalents (MME) and the number of pills prescribed (equivalent to 5 mg hydrocodone). RESULTS: Between 2014 and 2019, 169 patients (90 men, 79 women) met inclusion criteria, with a mean age of 46.9 years. Surgery resulted in a statistically significant improvement in VAS (Visual Analogue Scale) score (6.4 to 2.5, P < .01). At discharge, 8 patients (4.7%) did not receive any opioid prescription. Of the remaining 161 patients, 1 patient (0.01%) received hydromorphone, 30 (18.6%) Percocet, 43 (26.7%) oxycodone, and 87 Norco (54.0%). The length of opioid prescription was 6.7 days. The maximum daily dosage of opioids prescribed was 70.4 MME (SD 32.1). The total number of pills prescribed was 89.4 (SD 54.7). Twenty-five patients (15.5%) received a refill prescription. Multivariate analysis demonstrated the operating service, prescriber, and hospital admission were statistically significant predictors of maximum daily MME. The prescriber and hospital admission were statistically significant predictors of total number of pills prescribed. CONCLUSIONS: We found significant variability in opioid prescription following primary single-level lumbar microdiscectomy. For standard spinal procedures like lumbar microdiscectomy, opioid-prescribing guidelines should be established to standardize postoperative pain management. |
format | Online Article Text |
id | pubmed-8907642 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-89076422022-03-11 Variability in Opioid Prescription Following Primary Single-Level Lumbar Microdiscectomy Le, Hai Phan, Eileen Agatstein, Lauren Barber, Joshua Klineberg, Eric Roberto, Rolando Javidan, Yashar Global Spine J Original Articles STUDY DESIGN: Retrospective case series. OBJECTIVES: To evaluate the variability in opioid prescription following primary single-level lumbar microdiscectomy. METHODS: We retrospectively reviewed consecutive patients who underwent primary single-level lumbar microdiscectomy. Only opioid-naïve patients ≥18 years old were included. Patients who had revision microdiscectomy, multilevel decompression, and/or any complication requiring prolonged hospital stay (>2 days) were excluded. The primary outcomes were the maximum daily dosage of opioids prescribed in morphine milligram equivalents (MME) and the number of pills prescribed (equivalent to 5 mg hydrocodone). RESULTS: Between 2014 and 2019, 169 patients (90 men, 79 women) met inclusion criteria, with a mean age of 46.9 years. Surgery resulted in a statistically significant improvement in VAS (Visual Analogue Scale) score (6.4 to 2.5, P < .01). At discharge, 8 patients (4.7%) did not receive any opioid prescription. Of the remaining 161 patients, 1 patient (0.01%) received hydromorphone, 30 (18.6%) Percocet, 43 (26.7%) oxycodone, and 87 Norco (54.0%). The length of opioid prescription was 6.7 days. The maximum daily dosage of opioids prescribed was 70.4 MME (SD 32.1). The total number of pills prescribed was 89.4 (SD 54.7). Twenty-five patients (15.5%) received a refill prescription. Multivariate analysis demonstrated the operating service, prescriber, and hospital admission were statistically significant predictors of maximum daily MME. The prescriber and hospital admission were statistically significant predictors of total number of pills prescribed. CONCLUSIONS: We found significant variability in opioid prescription following primary single-level lumbar microdiscectomy. For standard spinal procedures like lumbar microdiscectomy, opioid-prescribing guidelines should be established to standardize postoperative pain management. SAGE Publications 2020-08-28 2022-03 /pmc/articles/PMC8907642/ /pubmed/32856480 http://dx.doi.org/10.1177/2192568220950678 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Le, Hai Phan, Eileen Agatstein, Lauren Barber, Joshua Klineberg, Eric Roberto, Rolando Javidan, Yashar Variability in Opioid Prescription Following Primary Single-Level Lumbar Microdiscectomy |
title | Variability in Opioid Prescription Following Primary Single-Level
Lumbar Microdiscectomy |
title_full | Variability in Opioid Prescription Following Primary Single-Level
Lumbar Microdiscectomy |
title_fullStr | Variability in Opioid Prescription Following Primary Single-Level
Lumbar Microdiscectomy |
title_full_unstemmed | Variability in Opioid Prescription Following Primary Single-Level
Lumbar Microdiscectomy |
title_short | Variability in Opioid Prescription Following Primary Single-Level
Lumbar Microdiscectomy |
title_sort | variability in opioid prescription following primary single-level
lumbar microdiscectomy |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907642/ https://www.ncbi.nlm.nih.gov/pubmed/32856480 http://dx.doi.org/10.1177/2192568220950678 |
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