Use of Ketorolac After Outpatient Urogynecologic Surgery: A Randomized Control Trial

Trowbridge, Elisa R.; Kim, Dahea; Caldwell, Lauren; Franko, Denise; Jackson, John; Shilling, Ashley; Hullfish, Kathie L.

doi:10.1097/spv.0000000000000459

Cited by 9 publications

(1 citation statement)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 Intraoperative use of nonopiate medications, such as intravenous toradol and belladonna opium suppositories have been shown to help with postoperative pain control after ureteroscopy. 11,24 Notably in this study, no surgical factors were identified as risk factors for persistent opiate use, including stent duration or sheath use. After surgery, providing a standardized MED per postoperative opiate prescription may help minimize the quantity of opiates prescribed and/or unused by patients.…”

Section: Discussionmentioning

confidence: 75%

Opiate Exposure and Predictors of Increased Opiate Use After Ureteroscopy

Kang

Shu

Herrell

et al. 2019

Journal of Endourology

View full text Add to dashboard Cite

Objective: Kidney stone formers are at risk for opioid dependence. The aim of this study is to describe opiate exposure and determine predictors of prolonged opiate use among kidney stone formers after surgery. Materials and Methods: A retrospective review was performed among patients who underwent ureteroscopy for upper tract stone disease. Prescription data were ascertained from a statewide prescribing database. Demographic data and surgical factors were collected from the electronic medical record. Predictors of additional postsurgery prescriptions filled within 30 days and persistent opiate use 60 days after ureteroscopy were determined. Results: Among 208 patients, 127 (61%) had received preoperative opiate prescriptions within 30 days before surgery. Overall, 12% (n = 25) of patients required an additional opiate prescription within 30 days after ureteroscopy, and 7% (n = 14) of patients continued to use opiate medications more than 60 days postoperatively. Patients continuing to use opiates long-term were not chronic opiate users. For both outcomes, preoperative opiate exposure, including number of prescriptions, days prescribed, and unique providers had significant associations (all p < 0.05). Additionally, younger age (p = 0.049) was associated with obtaining an additional opiate prescription within 30 days. Lower BMI (p = 0.02) and higher ASA score (p = 0.03) were predictors of continued opiate use more than 60 days after ureteroscopy. Conclusions: The majority of stone formers have had opiate exposure before surgery, often from multiple providers. Approximately 1 in 8 stone formers who undergo ureteroscopy require additional opiate prescriptions within 30 days. A small but significant population receive opiates beyond the immediate postoperative period.

show abstract

Section: Discussionmentioning

confidence: 75%