PostOp Pain Management Prescription Guidelines

General Principles

  • The following are guidelines that are designed as a template for other institutions to design their guidelines
  • Due to various factors guidelines cannot be applied to all patients
    • Current provider compliance at our institution is just above 90%
  • The single most important factor leading to opioid misuse is the total amount dispensed (Brat et al., BMJ 2018)
  • Using these guidelines has led to a 50% decrease in the amount of opioids prescribed
  • Alternating ibuprofen and acetaminophen postoperatively is recommended
  • However, non-acetaminophen derived opioids can be difficult to obtain in many regions of the country
  • Therefore, two sets of guidelines are provided
    • Acetaminophen derived opioids
    • Non-acetaminophen derived opioids

Use of the Guidelines

  1. Did the patient have a Mild, Moderate, Major procedure or Spinal Fusion?
  2. Does the patient prefer pill or liquid medicine?
  3. What is the patient’s weight?
  4. Is this the first or second prescription?

Download Guidelines