To describe predictors of patient satisfaction with pain control including opioid prescribing practices, patients undergoing minor gynaecologic and urogynaecologic surgeries were included in a prospective cohort study. Satisfaction with postoperative pain control by opioid prescription status was analysed using bivariate analysis and multivariable logistic regression, controlling for potential confounders. Among participants completing both postoperative surveys, 112/141 (79.4%) reported pain control satisfaction by day 1-2 and 118/137 (86.1%) by day 14. While we were underpowered to detect a true difference in satisfaction by opioid prescription, there were no differences in opioid prescription among patients satisfied with pain control [52% vs. 60% ( = .43) among satisfied patients at day 1-2 and 58.5% vs. 37% ( = .08) at day 14]. Significant predictors of pain control satisfaction were postoperative day (POD) 1-2 average pain at rest [aOR 0.72 (95% CI 0.52-0.99), = .04], rating of shared decision-making [aOR 1.16 (95% CI 1.004-1.34), = .04], amount of pain relief [aOR 1.28 (95% CI 1.07-1.54), = .008) and POD 14 shared decision-making rating [aOR 1.45 (95% CI 1.19-1.77), = .002].Impact Statement There are little data published on opioid prescription rates after minor gynaecologic procedures and no formal evidence-based guidance for gynaecologic providers for opioid prescribing. Few publications describe rates of opioid prescription and use following minor gynaecologic procedures. In the setting of a dramatic escalation of opioid misuse in the United States over the last decade, we sought to describe our practice of opioid prescription following minor gynaecologic procedures and answer the question of whether patient satisfaction is affected by opioid prescription, fill and use. Though underpowered to detect our primary outcome, our results suggest that patient satisfaction with pain control may primarily be significantly affected by the patient's subjective assessment of shared decision-making with the gynaecologist. Ultimately, these preliminary findings suggest a larger cohort is needed to answer the question of whether pain control satisfaction is influenced by receipt/fill/use of opioids after minor gynaecologic surgery.
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http://dx.doi.org/10.1080/01443615.2023.2171773 | DOI Listing |
Curr Med Chem
January 2025
Department of Surgery, School of Medicine, Nazarbayev University, 5/1 Kerey and Zhanibek khandar str., 020000, Astana, Kazakhstan.
Understanding and managing pain in patients with terminal cancer is a vital aspect of palliative care, aimed at relieving suffering and improving quality of life in the final stages of illness. Studies indicate that approximately 50% of patients with stage 4 cancer report moderate to severe pain, with a quarter experiencing severe cancer-related pain. Despite opioid prescriptions in 97% of cases, a significant portion of patients continues to suffer unresolved pain during the last week of life.
View Article and Find Full Text PDFBiostatistics
December 2024
Department of Statistical Sciences, College of Arts and Sciences, Wake Forest University, 127 Manchester Hall, Winston-Salem, NC, 27109, United States.
The opioid epidemic is a significant public health challenge in North Carolina, but limited data restrict our understanding of its complexity. Examining trends and relationships among different outcomes believed to reflect opioid misuse provides an alternative perspective to understand the opioid epidemic. We use a Bayesian dynamic spatial factor model to capture the interrelated dynamics within six different county-level outcomes, such as illicit opioid overdose deaths, emergency department visits related to drug overdose, treatment counts for opioid use disorder, patients receiving prescriptions for buprenorphine, and newly diagnosed cases of acute and chronic hepatitis C virus and human immunodeficiency virus.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Department of Orthopaedics; University Hospital Cleveland Medical Center, Cleveland, OH, USA.
Background: Recurrent shoulder dislocations often lead to multiple encounters for reduction and eventual surgical stabilization, both of which involve exposure to opioids and potentially increase the risk of chronic opioid exposure. The purpose of our study was to characterize shoulder instability and compare pre- and post-reduction opioid usage in singular dislocators (SD) and recurrent dislocators (RD).
Methods: This retrospective study was performed at a single academic institution using a prospective database.
Rev Esp Anestesiol Reanim (Engl Ed)
January 2025
Servicio de Anestesiología y Reanimación, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Departamento de Medicina Legal, Psiquiatría y Patología, Universidad Complutense, Madrid, Spain. Electronic address:
Introduction: Postoperative pain in ambulatory surgery (AS) continues to be a recurrent problem despite anesthetic and surgical advances. Analgesic prescription and follow-up by patients at home may be a determining factor. Our objective was to evaluate analgesic prescription and its impact on the intensity of postoperative pain at 24 h and 7 days in an AS unit.
View Article and Find Full Text PDFAm J Emerg Med
January 2025
Departments of Emergency Medicine (EM) and Community Health Sciences, University of Calgary, Canada.
Study Hypothesis: Use of opioids for treatment of headache in the emergency department (ED) is associated with an increased 1-year risk of opioid-related adverse events.
Objective: To assess the safety and efficacy of opioid prescribing for ED patients with headache.
Methods: We performed a multicenter observational cohort study using linked administrative data.
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