University of Virginia cuts opioid use and improves pain scores
Key Takeaways
The University of Virginia Health System has improved postoperative pain scores while decreasing the amount of prescribed opioids, a new report says.
Anesthesiologists at UVA reviewed more than 100,000 surgeries and found that self-reported pain scores improved 31%, even as opioid prescriptions per surgery decreased by 37%.
“There is clear evidence that people can become opioid dependent because of the drugs they get during and after surgery,” said Marcel E. Durieux, MD, PhD, one of three UVA anesthesiologists who conducted the study. “I think that by substantially limiting opioids during surgery, we’ve made an important step in addressing that problem.”
As a new push gears up across the US for ways to combat the opioid epidemic, UVA researchers believe they have found an effective way to address some aspects of the problem.
Dr. Durieux identified two successful factors in the improvement in patients’ pain. First, a decrease in the amount of opioids given to patients may improve pain scores on its own. Research has shown that opioids can make patients more sensitive to pain, although the exact mechanism remains unclear.
The second factor was the significant increase in the administration of non-opioid pain medications, such as acetaminophen and lidocaine.
The average amount of non-opioid pain medications increased 120% per surgical case at UVA during the study period. Dr. Durieux notes that while non-opioid drugs have a lower risk for addiction and abuse, they cannot be used in every case due to the risk for bleeding and kidney damage.
UVA is no stranger to efforts to decrease opioid use. Anesthesiologist in the UVA Health System regularly share data about the benefits of using fewer opioids. In 2013, UVA implemented the Enhanced Recovery after Surgery program. The program limited opioid prescription for patients undergoing colorectal surgery.
These findings were presented in December 2016 at the PostGraduate Assembly in Anesthesiology, New York, NY. The study was presented by Gregory A. Smith, MD; Durieux; and Bhiken I. Naik, MBBCh.