Hernia Patients May Need Fewer Opioids After Surgery, Study Finds

After repair, smaller prescriptions led to fewer pills that could be diverted or abused

MONDAY, Aug. 21, 2017 (HealthDay News) -- Hernia surgery patients may require far fewer opioid painkillers than they're prescribed, new research suggests.

The study included 186 adult patients who had elective inguinal ("groin") hernia repair surgery under local anesthesia with intravenous sedation.

Each patient received a prescription for 10 tablets of the opioid painkiller Vicodin (hydrocodone/acetaminophen) to ease their post-surgery pain. But they were also encouraged to use non-opioid medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to manage their pain whenever possible.

The researchers found that 86 percent of the patients used less than half of their prescribed Vicodin. Almost two-thirds used no Vicodin at all, relying totally on non-opioid pain medications.

"The implication of our study is that, even though surgeons have been careful to limit the number of opioid tablets that we prescribe following operations, we may still be prescribing more medication than is actually needed by our patients," study senior author Dr. Peter Masiakos, from Massachusetts General Hospital, said in a hospital news release.

Masiakos said the findings need to be replicated at other practices and hospitals. But in the meantime, his hospital has initiated a change in how it prescribes these drugs.

"These results suggest that we should take a detailed look at our patient's experiences and our prescribing habits to really determine how much opioid medication we should provide our patients," Masiakos said.

He said that writing smaller prescriptions "should help reduce the number of extra opioid tablets that could be diverted or abused. Patients who experience more pain than expected or need more pain tablets than they are prescribed would alert us to the possibility of a postoperative problem that might need attention."

Data suggest that as many as 6 percent of patients who are prescribed opioids after surgery become addicted to the drugs. The risk may be even higher among patients who are prescribed longer-term, higher-dose opioid treatment.

One recent study found that patients were prescribed an average of 30 opioid tablets after hernia repair surgery and recommended reducing that to 15 tablets.

The study was published online recently in the journal Surgery.

More information

The U.S. Centers for Disease Control and Prevention has more on prescription opioids (https://www.cdc.gov/drugoverdose/opioids/prescribed.html ).

-- Robert Preidt

SOURCE: Massachusetts General Hospital, news release, August 2017

Please note, not all procedures included in this resource library are available at Henry Ford Allegiance Health or performed by Henry Ford Allegiance Health physicians.

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