Most heart surgery patients will not have to take opioids after discharge, study says

Most heart surgery patients will not have to take opioids after discharge, study says

Chicago - January 15 ANI According to a new study, many heart surgery patients won't have to take opioids for pain after being discharged from the hospital.

The research was published in The Annals of Thoracic Surgery Journal.

In some cases, patients assume that they will need to go home with prescription pain medicine after surgery, especially a big operation like cardiac surgery, said Catherine M. Wagner, MD, from the University of Michigan in Ann Arbor.

After cardiac surgery, the discharge without opioid pain medicine is well tolerated by some patients. She said that we should not be reflexively prescribing pain medicine to people after surgery just in case they need it.

In a series of studies, Dr Wagner and colleagues examined data from 2019 for patients who underwent coronary artery bypass grafting CABG heart valve surgery, or a combination of those operations via the median sternotomy a vertical incision in the centre of the chest at 10 centers participating in the Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative.

More than one-fourth of patients 547 1,924 or 28 per cent did not receive an opioid prescription at the time of discharge, according to the researchers. Patients who were older, spending more time in the hospital after surgery, or who underwent surgery and were discharged during the last 3 months of the study period, October-December, were more likely to leave the hospital without an opioid prescription.

Patients with a history of depression, those who were treated with opioids on the day prior to discharge, or patients whose race was non-black and non-white were more likely to receive an opioid prescription at discharge.

Despite the fact that discharge without an opioid prescription appeared to have been well-tolerated, as fewer than 2 per cent of patients required a prescription after discharge and before their 30 day follow-up appointment.

The findings should give patients reassurance that postoperative pain can be managed at home with non-opioid pain medications, said Dr Wagner.

415 46 per cent of the 909 patients who did not take any opioids on the day before discharge received an opioid prescription at discharge, according to the researchers.

"One should consider if these opioid prescriptions were really necessary for patient pain relief," said Dr Wagner.

Our study shows that discharge without opioids is safe for patients who did not take any opioids on the day before they leave the hospital. She said that we need to make sure that only patients who need opioids are sent home with a prescription.

Opioid addiction is taking a big toll on lives in the US. More than 70 per cent of overdose deaths in 2019 -- more than 49,000 deaths -- involved opioids, according to the US Centers for Disease Control and Prevention CDC In 2021, more than 100,000 Americans died of drug overdoses 28.5 per cent more than the year before the CDC reported that the main driver of these deaths was opioids.

"For decades, surgeons have unwittingly contributed to the opioid epidemic," said Thomas E. MacGillivray, MD, of Houston Methodist in Texas, who was not directly involved in the research.

No one wants a patient discharged home after surgery without adequate pain relief. With the best intentions to help relieve pain and relieve anxiety about pain, discharge practices have often erred on the side of prescribing too many narcotic pain pills rather than too few. We have learned that many of the unused, unneeded narcotics end up in the community. He said this study will help surgeons identify patients who may be discharged home without narcotics.

Prior to the emergence of the opioid epidemic, patients would often be prescribed 50 to 100 opioid pills after surgery for various reasons, according to Dr Wagner. Unrelated research has shown that leftover medication can be diverted into the community, contributing to the opioid epidemic.

She said that with increased attention on the excessive prescribing of opioids for pain treatment after surgery, national efforts such as prescribing guidelines and patient education programs have begun to limit unnecessary opioids in the community and reduce the risks of developing new persistent opioid use in patients.

The researchers want to make sure that only patients who need opioids are sent home with a prescription, while avoiding just in case prescriptions that leave unnecessary opioids in communities and put patients and their family at risk from the opioid diversion.