Decreasing postoperative narcotic use for patients undergoing hysterectomy
Chopra V, Kown D, and Sangha R. Decreasing postoperative narcotic use for patients undergoing hysterectomy. J Minimally Invasive Gynecol 2018; 25(7):S194.
J Minimally Invasive Gynecol
Objective: Opioid overdose epidemic has continued to be on the rise in recent years. Our study is aimed to decreasing physician prescribed narcotics postoperatively after hysterectomy. Design: Prospective Quality Improvement study. Settings: Academic affiliated community hospital located in inner city Detroit, Michigan. Patients: Patients undergoing hysterectomy for non-cancerous and cancerous disease via minimally invasive approach or open approach. Interventions: Identified baseline opioid prescribing practices, select reduced opioid prescribing target and implementing the new prescribing practices. Measurements/Results: We looked at the average number of narcotics prescribed after hysterectomy, whether minimally invasive (MIS) or open approach and whether surgery indicated for cancer or noncancerous disease. We broke up the year into 46 cycles, with 8 days included into each cycle and 5 hysterectomies to give us an average of 200 hysterectomies per year to base our study on. Based on this data from 07/2017 - 01/2018 (6 month period - approximately 100 cases), we found that physicians at our institution prescribed an average of 36.21 opioid pills at discharge. We followed up with these patients at 30 days postoperatively via phone call to determine the amount of narcotics consumed by the patient. Conclusions: In conclusion, we determined that providers at our institution over prescribe narcotics in comparison to how many pills are actually taken by the patient regardless of an MIS approach or open approach and irrespective of cancer or noncancerous reason for hysterectomy. [Figure presented]