Evidence map›Paper›PMID 39400599›Full record

ArticleSurgical endoscopy2025

Opioid use patterns following discharge from elective colorectal surgery: a prospective cohort study.

Ghadeer Olleik, Maxime Lapointe-Gagner, Shrieda Jain, Samin Shirzadi, Philip Nguyen-Powanda, Sarah Al Ben Ali, Tahereh Najafi Ghezeljeh, Hiba Elhaj, Naser Alali, Francesca Fermi and 12 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Ghadeer OlleikDepartment of Surgery, McGill University, Montreal, QC, Canada.
Maxime Lapointe-GagnerDepartment of Surgery, McGill University, Montreal, QC, Canada.
Shrieda JainDepartment of Surgery, McGill University, Montreal, QC, Canada.
Samin ShirzadiCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Philip Nguyen-PowandaDepartment of Surgery, McGill University, Montreal, QC, Canada.
Sarah Al Ben AliDepartment of Surgery, McGill University, Montreal, QC, Canada.
Tahereh Najafi GhezeljehCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Hiba ElhajCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Naser AlaliDepartment of Surgery, McGill University, Montreal, QC, Canada.
Francesca FermiDepartment of Surgery, McGill University, Montreal, QC, Canada.
Makena PookDepartment of Surgery, McGill University, Montreal, QC, Canada.
Christos MousoulisCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Ahmad AlmusaileemDepartment of Surgery, McGill University, Montreal, QC, Canada.
Nardin FaragPerioperative Care and Outcomes Research (PCOR) Lab, McGill University, Montreal, QC, Canada.
Katy DmowskiDepartment of Surgery, McGill University, Montreal, QC, Canada.
Danielle CutlerPerioperative Care and Outcomes Research (PCOR) Lab, McGill University, Montreal, QC, Canada.
Pepa KanevaCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Ramanakumar V AgnihotramCentre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
Liane S FeldmanDepartment of Surgery, McGill University, Montreal, QC, Canada.
Marylise BoutrosDepartment of Surgery, McGill University, Montreal, QC, Canada.
Lawrence LeeDepartment of Surgery, McGill University, Montreal, QC, Canada.
Julio F FioreDepartment of Surgery, McGill University, Montreal, QC, Canada. julio.fiorejunior@mcgill.ca.ORCID 0000-0002-0019-8673

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOpioid overprescription after colorectal surgery can lead to adverse events, persistent opioid use, and diversion of unused pills. This study aims to assess the extent to which opioids prescribed at discharge after elective colorectal surgery are consumed by patients.

methodsThis prospective cohort study included adult patients (≥ 18 yo) undergoing elective colorectal surgery at two academic hospitals in Montreal, Canada. Patients completed preoperative questionnaires and data concerning demographics, surgical details, and perioperative care characteristics (including discharge prescriptions) were extracted from electronic medical records. Self-reported opioid consumption was assessed weekly up to 1-month post-discharge. The total number of opioid pills prescribed and consumed after discharge were compared using the Wilcoxon signed-rank test. Negative binomial regression was used to identify predictors of opioid consumption.

resultsWe analyzed 344 patients (58 ± 15 years, 47% female, 65% laparoscopic, 31% rectal resection, median hospital stay 3 days [IQR 1-5], 18% same-day discharge). Most patients received a TAP block (67%). Analgesia prescription at discharge included acetaminophen (92%), NSAIDs (38%), and opioids (92%). The quantity of opioids prescribed at discharge (median 13 pills [IQR 7-20]) was significantly higher than patient-reported consumption at one month (median 0 pills [IQR 0-7]) (p < 0.001). Overall, 51% of patients did not consume any opioids post-discharge, and 63% of the prescribed pills were not used. Increased opioid consumption was associated with younger age (IRR 0.99 [95%CI 0.98-0.99]), higher preoperative anxiety (1.02 [95%CI 1.00-1.04]), rectal resections (IRR 1.45 [95%CI 1.09-1.94]), and number of pills prescribed (1.02 [95%CI 1.01-1.03]).

conclusionA considerable number of opioid pills prescribed at discharge after elective colorectal surgery are left unused by patients. Certain patient and care characteristics were associated with increased opioid consumption. Our findings indicate that post-discharge analgesia with minimal or no opioids may be feasible and warrants further investigation.

Indexed as

Analgesics, OpioidElective Surgical ProceduresPatient DischargePostoperative PainAdultAgedFemaleHumansMaleMiddle AgedPractice Patterns, Physicians'Prospective StudiesAnalgesics, OpioidColorectal surgeryOpioidsPerioperative carePostoperative analgesia

Identifiers

PMID39400599

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.