Most significant was the prescribing patterns. Patients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively.
Best of the Best Gen Surg - Predictors of Low and High Opioid Tablet Consumption after Inguinal Hernia Repair – an ACHQC Opioid Reduction Task Force Analysis - Dr. Warren
▶Ep 13 · 0:21
quoteI first want to thank Drs. Rosen and Ponsky for putting together this session and allowing me to participate.↗
▶Ep 13 · 1:50
quoteit's really critical for us to understand that the transition to synthetic opioids and heroin often begins with exposure to prescribed opioids.↗
▶Ep 13 · 3:10
epidemiologicalMore than 60 percent of inguinal hernia patients in a Greenville study required no opioid consumption↗
▶Ep 13 · 3:20
quoteWe know that overprescribing increases the risk of opioid misuse and abuse, so it's really imperative that we as surgeons recognize our role in helping to fix this problem.↗
▶Ep 13 · 3:40
clinicalThe ACHQC is a national hernia-specific registry containing over 100,000 patients↗
▶Ep 13 · 4:20
epidemiologicalOver 80 percent of patients reported taking less than 10 pills after inguinal hernia repair↗
▶Ep 13 · 4:30
epidemiologicalOver 50 percent of patients reported taking no opioids at all after inguinal hernia repair↗
▶Ep 13 · 4:40
clinicalYounger age, smokers, ASA 3 or 4, preoperative opioid use, open mesh repairs, longer operative times, and worse baseline quality of life increased the risk of high opioid consumption post-op↗
▶Ep 13 · 4:45
clinicalThe study analyzed 1,937 patients undergoing elective, clean inguinal hernia repair with completed 30-day follow-up and complete opioid data↗
▶Ep 13 · 5:00
clinicalPatients were at significantly higher risk of opioid consumption when prescribed a higher volume of pills↗
▶Ep 13 · 5:00
epidemiological59 percent of cases were minimally invasive inguinal hernia repairs (lap and robotic), 35 percent open mesh repairs, and 6 percent open tissue repairs↗
▶Ep 13 · 5:10
clinicalHistory of smoking increases the risk of opioid consumption after inguinal hernia repair↗
▶Ep 13 · 5:15
epidemiologicalPatients reported consuming zero narcotics in 50 percent of cases, with only 8 percent reporting more than 10 tablets consumed↗
▶Ep 13 · 5:20
clinicalPatients with prior or recent opioid use are at higher risk of post-operative opioid consumption, supporting avoidance of prescribing opioids for hernia-related pain prior to surgery↗
▶Ep 13 · 5:30
clinicalOlder age, ASA 1 or 2, use of local anesthetic, use of sedation versus general anesthetic, and shorter operative time all increased the chances that patients would use zero narcotics post-op↗
▶Ep 13 · 5:35
clinicalMinimally invasive approach and use of local anesthetic are surgeon-modifiable factors that reduce opioid consumption↗
▶Ep 13 · 5:40
quoteWe can see empirically that patients just do not need a just-in-case medication and that this in fact increases their risk of higher consumption.↗
▶Ep 13 · 5:45
clinicalPatient-reported opioid use is significantly impacted by surgeon prescribing↗
▶Ep 13 · 5:45
quoteMost significant was the prescribing patterns. Patients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively.↗
▶Ep 13 · 5:50
clinicalPatients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively↗
Summaries Jeremy gave as host
· 6 summaries
Recaps of other experts' statements, not Jeremy's own clinical position.
Summaries Jeremy gave as host · Inguinal Hernia6 summaries
Best of the Best Gen Surg - Predictors of Low and High Opioid Tablet Consumption after Inguinal Hernia Repair – an ACHQC Opioid Reduction Task Force Analysis - Dr. Warren
▶Ep 13 · 1:30
host summaryJeremy Warren summarizes what Dr. Todd Ponsky said: Over half a million opioid-related deaths occurred in the last 20 years↗
▶Ep 13 · 1:40
host summaryJeremy Warren summarizes what Dr. Todd Ponsky said: Prescription opioid-related deaths increased by 17% in the last year↗
▶Ep 13 · 1:50
host summaryJeremy Warren summarizes what Dr. Todd Ponsky said: Transition to synthetic opioids and heroin often begins with exposure to prescribed opioids↗
▶Ep 13 · 2:05
host summaryJeremy Warren summarizes what Dr. Todd Ponsky said: A 2017 Dartmouth study demonstrated wide range of surgeon prescribing patterns for common procedures and that patients typically consume dramatically less opioid than prescribed↗
▶Ep 13 · 2:35
host summaryJeremy Warren summarizes what Dr. Todd Ponsky said: Patients were prescribed between 15 and 120 opioid tablets after inguinal hernia repair, with an average of over 30 pills prescribed↗
▶Ep 13 · 2:55
host summaryJeremy Warren summarizes what Dr. Todd Ponsky said: Patients reported taking only 15 to 30 percent of prescribed tablets after inguinal hernia repair↗
