Opioid prescriptions after minor to moderate surgeries do not reduce pain after patient discharge, according to a new meta-analysis.
Researchers found that opioid prescriptions 1 day after hospital discharge did not reduce pain compared with opioid-free pain medications . They also found that opioid prescriptions did not better control a patient's pain for up to 30 days following the surgery. Patients prescribed opioids were more than four times as likely to experience vomiting after surgical discharge 4.50; 95% CI, 1.93 - 10.51).
"We are living the era of evidence-based practice, and our research shows that the prescription of opioids at discharge after surgery is clearly not supported by evidence," Fiore noted."Unfortunately, alternatives to opioids are often overlooked by North American surgeons, while they should be incorporated as the foundation of postoperative analgesia whenever possible."
But Karim Ladha, MD, MSc, an anesthesiologist at St. Michael's Hospital and the University of Toronto, Canada, is wary of changing pain management practices based on this analysis alone. The paper"brings forth some data that shows that it is possible to not use opioids after surgery, without necessarily affecting patients' experience with pain or satisfaction after the procedure," he told.
The studies included in the systematic review only comprised a small subset of surgeries, and many procedures were dental work, he said. The trials selected for the analysis were generally considered low-quality, meaning they had a higher risk of bias such as potential for selective reporting and deviation from the intended interventions, Fiore acknowledged.
Because the surgeries and patients were grouped together for the meta-analysis, the research also does not highlight if certain surgical procedures or if certain patients would more greatly benefit from opioids to control pain after surgeries.
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