zero, opioids to the patient, the patient will feel more post-operative pain and
be less satisfied with their care. They also want to avoid patients' request for
refills, so they provide more pills than necessary up front, just in case.
Dr. Brummett and his colleagues have found these concerns to be base-
less. "Our group and others have shown that there really does not appear
to be an association between the number of opioid pills prescribed and
patient satisfaction for their care — or their likelihood of refill," he says.
Individualized regimens
While much work has been put into standardizing prescriptions based
on procedure type, there's a complementary factor that still needs
work: tailoring opioid prescriptions not only to procedures, but also
to individual patients. "We need to learn a little bit more about which
patients are going to require more pills than others," says Dr. Hannon.
Standardizing prescriptions by procedure type makes things a lot
easier from an administrative point of view, but tailoring those stan-
J A N U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 3 7
• hernia repair (minor or major) 0-10
• sleeve gastrectomy 0-10
• laparoscopic cholecystectomy 0-10
• prostatectomy 0-10
• open cholecystectomy 0-15
• colectomy (lap or open) 0-15
• hysterectomy 0-15
• open small bowel resection 0-20
• total hip arthroplasty 0-30
• total knee arthroplasty 0-50
Full guidelines available at no cost at
michigan-open.org/prescribing-recommendations
