Characterizing the Effect of Perioperative Narcotic Consumption and Narcotic Prescription Dosing at Discharge on Satisfaction With Pain Control for Patients Undergoing Single-level Anterior Cervical Discectomy and Fusion. Academic Article uri icon

Overview

abstract

  • STUDY DESIGN: A single-center, retrospective review of prospectively collected data on patients who underwent single-level anterior cervical discectomy and fusions (ACDFs) between October 2014 and October 2019. OBJECTIVE: To investigate the effect of perioperative narcotic consumption and amount of narcotic prescribed at discharge on patient satisfaction with pain control after single-level ACDF. SUMMARY OF BACKGROUND DATA: Prior research has demonstrated that opioid prescription habits may be related to physician desire to produce superior patient satisfaction with pain control. METHODS: Patients with complete Press-Ganey Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey information were analyzed. Inpatient opioid prescriptions were recorded and converted to milligram morphine equivalents (MME) and tablets of 5 mg oxycodone. HCAHPS scores were converted to a Likert-type 5-point scale. RESULTS: A total of 47 patients met inclusion criteria for this study. Average age was 48.1±10.9 y. Average inpatient opioids prescribed was 102±106 MME. Average opioids prescribed at discharge was 437±342 MME. No statistically significant correlation was found between satisfaction with pain control and opioid consumption while in the hospital [r=-0.106, P=0.483]. Similarly, there was no statistically significant correlation between satisfaction with pain control and opioids prescribed upon discharge [r=-0.185, P=0.219]. No statistically significant correlation was found between date of surgery and inpatient MME consumption [r=-0.113, P=0.450]. Interestingly, more opioids were prescribed at discharge the earlier the date of surgery [r=-0.426, P=0.003]. For every additional month further along in the study period, the odds of a patient reporting a top box score for satisfaction with pain control increased by 5.5% [P=0.025]. CONCLUSION: Our study found no correlation between patient satisfaction with pain control and inpatient opioid dosage or outpatient prescription dosage after single-level ACDF. Moreover, satisfaction with pain control increased over time despite a decrease in MME prescribed at discharge. This suggests that factors other than narcotic consumption play a more important role in patient satisfaction with pain control. LEVEL OF EVIDENCE: Level III.

publication date

  • December 15, 2021

Research

keywords

  • Analgesics, Opioid
  • Narcotics

Identity

Scopus Document Identifier

  • 85121987591

Digital Object Identifier (DOI)

  • 10.1097/BSD.0000000000001279

PubMed ID

  • 34907928

Additional Document Info

volume

  • 35

issue

  • 5