Overprescribed opioids after caesarean section: study

Carol Tanzer Mirror
Health Day Reporter

Thursday, June 8, 2017 (HealthDay News)-Three new studies suggest that women are routinely prescribed more opioid analgesics than they need after a caesarean section and are at increased risk of misuse.

Caesarean section is the most common inpatient surgery in the United States, with 1.4 million operations performed annually, according to researchers.However, there is little data on the amount of medication patients actually need to manage themselves. pain.. To that end, the number of tablets prescribed depends on the provider, the researchers added.

More care is needed to limit the amount of leftovers Drug The study concluded that it could fall into the wrong hands. Most people who use opioids for non-medical reasons get opioids from friends and relatives who have unused medications. And the patient is unable to trap the leftovers, which can endanger the infant.

“We are the source of these excess opioids and we need to do more to control them, but we need to adjust it to get what the individual needs. Conformity-all prescriptions “. Dr. Sarah Osmundson, who led one of the three studies, said. She is an assistant professor of maternal-fetal medicine at Vanderbilt University in Nashville.

Addiction For prescription opioids such as Oxycodone (Oxycontin, Perco set)and Hydrocodone (Bicoprofen) Is spreading in the United States. According to one study, the number of deaths from opioid overdose has quadrupled in the last 15 years.

Women are unlikely to be obsessed with opioids later Caesarean section, Addiction Experts said non-opioids pain Relief should always be the treatment of choice first.

“We need to be aware of what the consequences of regular opioid prescriptions are-not just for the patient, but for anyone who may encounter her shelves,” said Dr. Mishka Turplan. I did. He is a member of the American College of Obstetrics and Gynecology Opioid and Addiction Medicine Working Group.

The largest of the three new studies by researchers at Brigham and Women’s Hospital and Harvard Medical School in Boston included 720. Caesarean section Patients at 6 US medical centers. About 85 percent met opioid prescriptions when they were discharged.

The study found that women were prescribed about twice as many pills as they used. On average, there were 15 left for each. There are 1.3 million caesarean sections annually in the United States, which is an estimated 20 million opioids that can be diverted and misused.

Researchers did not find any difference pain Score when comparing women by the number of prescribed tablets.But women who were prescribed more pills wound Studies show that until you use more tablets.

“This was of particular interest to us because it suggests that we set patient expectations based on the number of tablets we prescribed,” said corresponding author Dr. Brian Bateman. Said in the hospital news release. Bateman is responsible for obstetric anesthesia for Brigham and Women.

Studies suggest that treatments are not as simple as distributing fewer tablets.

In the second study, Osmundson’s team urged providers to fix the quantity. pain The medicines women actually use in hospitals-use more pills for those who need more pain relief as inpatients and fewer pills for others.

Of the 179 cesarean section patients they studied, 165 were prescribed opioids. Dosages ranged from 8 to 84 tablets, with nurses and midwives prescribing less than doctors.

More than three-quarters of patients left pills, and only seven women abandoned them. According to research, most of the leftovers were stored in unlocked cabinets.

The findings suggest that patient counseling is important.

Ozmundson said women should use opioids only when they really need them, taper off as soon as possible, and be careful to dispose of leftovers properly. Unused pills can be mixed with coffee shavings and kitten litter and dumped in the trash, or taken to an approved landfill, she said. Some medical practices also dispose of them.

Terplan, Deputy Director of Addiction Medicine at Virginia Commonwealth University in Richmond, said patients are responsible for asking questions and making sure they understand their treatment.

He said convenience may be one of the reasons for opioids that go beyond prescription.

Patients in need of more opioid painkillers need to get a written prescription-a trip to a doctor that may be a burden to new moms recovering from surgery and caring for them Newborn baby.. Therefore, the provider tries to make sure she has enough.

So what is an over-prescription prescription?

The third study investigated a new approach to reducing opioid use after caesarean section by 50%.

It revolved around a 10-minute meeting where clinicians talked about postoperative pain and opioids while patients watched a presentation on a tablet computer. Women were taught the expected amount of pain, the risks and benefits of opioid and non-opioid analgesics, how to obtain refills, and how to safely dispose of leftovers.


What are the opioids used for treatment?
See answer

Then the patient chose a number of 5 milligrams Oxycodone You can receive up to 40 tablets at the time of discharge, which is the usual number of tablets in the hospital. The median number of tablets they chose was 20. The average number of tablets left was four.

Nine out of ten participants said they were happy or very happy with themselves. Pain managementResearch shows that almost as many people find shared decisions helpful.

“I think this is the way forward,” Tarplan said. “I’m not saying that everyone takes 90 or 7 oxycontins, but they are actually involved in the patient’s own decision-making.”

The study was published online in the journal on June 8th. Obstetrics and gynecology..

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Source: Dr. Sarah Osmundson, Associate Professor of Maternal and Fetal Medicine, Vanderbilt University, Tennessee. Mishka Terplan, MD, Professor, Obstetrics, Gynecology, Psychiatry, Virginia Commonwealth University Addiction Medicine Deputy Director. Brigham and Women’s Hospital, News Release, June 8, 2017, Obstetrics and gynecology,online

Overprescribed opioids after caesarean section: study

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