Jeremy Warren
20 statements · 1 topic · summaries given as host listed separately
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Most significant was the prescribing patterns. Patients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively.
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Inguinal Hernia
We can see empirically that patients just do not need a just-in-case medication and that this in fact increases their risk of higher consumption.
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Inguinal Hernia
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Jeremy's statements about Inguinal Hernia 20 statements
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Best of the Best Gen Surg - Predictors of Low and High Opioid Tablet Consumption after Inguinal Hernia Repair – an ACHQC Opioid Reduction Task Force Analysis - Dr. Warren
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I first want to thank Drs. Rosen and Ponsky for putting together this session and allowing me to participate.
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it's really critical for us to understand that the transition to synthetic opioids and heroin often begins with exposure to prescribed opioids.
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More than 60 percent of inguinal hernia patients in a Greenville study required no opioid consumption
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We know that overprescribing increases the risk of opioid misuse and abuse, so it's really imperative that we as surgeons recognize our role in helping to fix this problem.
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Over 80 percent of patients reported taking less than 10 pills after inguinal hernia repair
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Over 50 percent of patients reported taking no opioids at all after inguinal hernia repair
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Younger age, smokers, ASA 3 or 4, preoperative opioid use, open mesh repairs, longer operative times, and worse baseline quality of life increased the risk of high opioid consumption post-op
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The study analyzed 1,937 patients undergoing elective, clean inguinal hernia repair with completed 30-day follow-up and complete opioid data
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Patients were at significantly higher risk of opioid consumption when prescribed a higher volume of pills
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59 percent of cases were minimally invasive inguinal hernia repairs (lap and robotic), 35 percent open mesh repairs, and 6 percent open tissue repairs
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History of smoking increases the risk of opioid consumption after inguinal hernia repair
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Patients reported consuming zero narcotics in 50 percent of cases, with only 8 percent reporting more than 10 tablets consumed
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Patients with prior or recent opioid use are at higher risk of post-operative opioid consumption, supporting avoidance of prescribing opioids for hernia-related pain prior to surgery
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Older age, ASA 1 or 2, use of local anesthetic, use of sedation versus general anesthetic, and shorter operative time all increased the chances that patients would use zero narcotics post-op
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Minimally invasive approach and use of local anesthetic are surgeon-modifiable factors that reduce opioid consumption
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We can see empirically that patients just do not need a just-in-case medication and that this in fact increases their risk of higher consumption.
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Most significant was the prescribing patterns. Patients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively.
Open
Statement
Patients with no opioid use prior to surgery or prescribed fewer than seven pills were the most likely to consume zero narcotics post-operatively
Open
Summaries Jeremy gave as host · 6 summaries
Recaps of other experts' statements, not Jeremy's own clinical position.
Summaries Jeremy gave as host · Inguinal Hernia 6 summaries
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Best of the Best Gen Surg - Predictors of Low and High Opioid Tablet Consumption after Inguinal Hernia Repair – an ACHQC Opioid Reduction Task Force Analysis - Dr. Warren
Host summary
Jeremy Warren summarizes what Dr. Todd Ponsky said: Over half a million opioid-related deaths occurred in the last 20 years
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Jeremy Warren summarizes what Dr. Todd Ponsky said: Prescription opioid-related deaths increased by 17% in the last year
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Jeremy Warren summarizes what Dr. Todd Ponsky said: Transition to synthetic opioids and heroin often begins with exposure to prescribed opioids
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Jeremy Warren summarizes what Dr. Todd Ponsky said: A 2017 Dartmouth study demonstrated wide range of surgeon prescribing patterns for common procedures and that patients typically consume dramatically less opioid than prescribed
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Jeremy Warren summarizes what Dr. Todd Ponsky said: Patients were prescribed between 15 and 120 opioid tablets after inguinal hernia repair, with an average of over 30 pills prescribed
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Host summary
Jeremy Warren summarizes what Dr. Todd Ponsky said: Patients reported taking only 15 to 30 percent of prescribed tablets after inguinal hernia repair
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