Plastic Surgery Research Council

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Opioid Prescribing Trends in Plastic Surgery
Katherine Rose, M.D..
University of Wisconsin, Madison, WI, USA.

PURPOSE: Opioid over-prescription is a nationwide problem contributing to the current opioid epidemic. Methods to reduce the frequency with which opioids are prescribed are being investigated across multiple disciplines. Currently, there are no data detailing the prescribing habits and need for post-operative narcotics for patients undergoing Plastic Surgery procedures. The goal of this study was to evaluate opioid consumption, physician prescribing practices, and patient satisfaction with post-operative pain control following Plastic Surgery procedures. METHODS: Patients who underwent inpatient and outpatient Plastic Surgery procedures were given a post-operative questionnaire inquiring about pain control and medication use. We queried about procedure type, quantity of opioids prescribed and used, day of opioid cessation, opioid refill status, subjective pain scores, concurrent use of non-opioid analgesics, and overall satisfaction with their pain control.
RESULTS: One hundred and sixty-five patients completed the survey. The most commonly prescribed opioids were hydrocodone-acetaminophen 5mg/325mg (42%) and oxycodone (39%). On average, patients took oral opioids for 4 days post-operatively. The average number of tablets prescribed was 27 (SD=12), and the average number of tablets consumed was 14 (SD=12). One of the more commonly surveyed procedures was breast reduction. Breast reduction patients required opioids for 6 days and, on average, were prescribed 25 pills but required 17 pills. This compares to non-breast soft tissue procedure patients who required opioids for 4 days and who were prescribed, on average, 27 pills and used 12 pills. Approximately 50% of all patients used non-steroidal anti-inflammatories and acetaminophen in conjunction with opioids to control post-operative pain. The majority of patients (93.3%) reported satisfaction with their pain control post-operatively with 79.4% being "very satisfied," 0.6% being "satisfied," 14.5% being "somewhat satisfied," and 3.6% being "not satisfied." On a numeric rating scale of 1-10, the average worst post-operative pain score was 6.1.
CONCLUSION: We found that, on average, providers are prescribing almost double the amount of opioids that are consumed by patients after Plastic Surgery procedures. The results of this study will help guide prescribing practices for common Plastic Surgery procedures performed and may ultimately lead to a reduction in over-prescribing of opioids after surgery.


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