An expert panel consensus on opioid-prescribing guidelines for dermatologic procedures - 11/02/20
for the
Opioid-Prescribing in Dermatology Workgroup∗
Abstract |
Background |
Opioid overprescribing is a major contributor to the opioid crisis. The lack of procedure-specific guidelines contributes to the vast differences in prescribing practices.
Objective |
To create opioid-prescribing consensus guidelines for common dermatologic procedures.
Methods |
We used a 4-step modified Delphi method to conduct a systematic discussion among a panel of dermatologists in the fields of general dermatology, dermatologic surgery, and cosmetics/phlebology to develop opioid prescribing guidelines for some of the most common dermatologic procedural scenarios. Guidelines were developed for opioid-naive patients undergoing routine procedures. Opioid tablets were defined as oxycodone 5-mg oral equivalents.
Results |
Postoperative pain after most uncomplicated procedures (76%) can be adequately managed with acetaminophen and/or ibuprofen. Group consensus identified no specific dermatologic scenario that routinely requires more than 15 oxycodone 5-mg oral equivalents to manage postoperative pain. Group consensus found that 23% of the procedural scenarios routinely require 1 to 10 opioid tablets, and only 1 routinely requires 1 to 15 opioid tablets.
Limitations |
These recommendations are based on expert consensus in lieu of quality evidence-based outcomes research. These recommendations must be individualized to accommodate patients' comorbidities.
Conclusions |
Procedure-specific opioid prescribing guidelines may serve as a foundation to produce effective and responsible postoperative pain management strategies after dermatologic interventions.
Le texte complet de cet article est disponible en PDF.Key words : opioid overuse, opioid guidelines, public health, Mohs micrographic surgery, dermatologic surgery, cosmetic dermatology, pain management, postoperative pain
Abbreviation used : MME
Plan
Funding sources: None. |
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Conflicts of interest: None disclosed. |
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IRB approval status: Approved (OUHSC IRB). |
Vol 82 - N° 3
P. 700-708 - mars 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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