Opioids may not be needed to manage pain after dermatologic surgery

Acetaminophen and ibuprofen may manage postoperative pain after dermatologic surgery while avoiding opioid exposure, according to a presentation at the American Society for Dermatologic Surgery annual meeting.

“The opioid epidemic is a national emergency. ... Among dermatologists, dermatologic surgeons prescribe the majority of opioids,” Kehinde O. Raji, MD, MPH, of Emory University School of Medicine, and colleagues wrote. “The goal of this study was to decrease the proportion of opioids prescribed and filled to less than 10% of surgeries performed and have a 0% increase in the amount of patient complaints regarding postoperative pain.”

In a single-center quality improvement intervention analysis, opioid prescription rates were obtained from the Georgia Prescription Drug Monitoring Program before implementation of the quality improvement initiative, 1 month after implementation and 6 months after implementation. The number of opioids prescribed and filled as well as telephone encounters relating to postoperative pain were compared preintervention and postintervention.

Study results showed the proportion of prescribed and filled opioid prescriptions decreased at 1 month after intervention (58% vs. 5%) and remained low at 6 months (4%). Additionally, a decrease in postoperative pain complaints was recorded and sustained (8.6% at baseline vs. 3.1% at 1 month and 4.9% at 6 months).

“Overall, our study suggests that postoperative pain in the dermatologic setting may be managed with acetaminophen and ibuprofen, lending further support to previous data,” the authors wrote. “We therefore propose to make this a guideline for all dermatologic surgeries.”