Patient Expect Opioids for Pain Control after Surgery

MedicalResearch.com Interview with:
"Surgery" by Army Medicine is licensed under CC BY 2.0Dr. Nirmal B. Shah
Anesthesia Resident PGY-IV (CA-III)
Thomas Jefferson University Hospital

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: With the ongoing opioid epidemic, we believe it is important to understand patients’ perceptions of pain medications and pain control after surgery. We believe patients’ expectations and perceptions regarding perioperative pain medications has not been well understood. We were hoping to understand patients’ knowledge, concerns, and biases of pain medication along with information to optimize acute pain management.

The goal of this survey study was to understand patient expectations regarding pain medications including opioids and non- opioids.  In the United States, over 100 million surgical procedures are performed every year. Nearly 80% of these patients will experience post-operative pain. Adequate treatment of post-operative pain has been shown to improve clinical and economic outcomes, thus there has been an increased effort towards improving post-operative pain control.

Through our research, we demonstrated that patients expect to experience postoperative pain after a surgical procedure and expect to be prescribed a pain medication. Patients believe that opioid medications will be most effective in treating postoperative pain compared to non-opioid medications, which could be contributing to the opioid epidemic.

503 patients presenting for elective surgery at Thomas Jefferson University Hospital in Philadelphia, PA were sampled during this survey. 76% of patients expected to be prescribed an opioid pain medication at discharge, 47% of patients expected to be prescribed acetaminophen (Tylenol) pain medication at discharge, while 30% of patients expected to be prescribed an NSAID (Motrin) pain medication at discharge. 94% of patients expecting to receive an opioid pain medication believe it would be effective in controlling their post-operative pain. This difference was not observed in patients expecting prescriptions for non-opioid pain medications. Overall, patients expect to experience pain after surgery and be prescribed analgesics they perceived to be most effective, opioids.

MedicalResearch.com: What should readers take away from your report?

Response: Patient education may be needed in order to demonstrate opioid medications are not always the most superior analgesics. With increased use of multimodal techniques, we hope patients will begin to accept non-opioid therapy after surgery. As the opioid crisis continues, cultural attitudes toward pain and medications will play a central role in reducing the prevalence of opioids in healthcare and society. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: I would like to perform this study in patients presenting for elective surgery at a community based medical center and see if there are any differences in patients’ perceptions and expectations about perioperative pain medications in an urban vs non-urban setting.

I do not have any financial disclosures.

Citation:

ANESTHESIOLOGY® 2018 abstract discussing:

Source Reference: Shah N, et al “Patient perceptions and expectations about postoperative analgesia” ASA 2018; Abstract A1011.

Oct 29, 2018 @ 8:25 pm 

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