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NATIONAL TRENDS IN PERIOPERATIVE OPIOID PRESCRIBING FOR AMBULATORY INGUINAL HERNIA REPAIR
Patrick C. Brown
*, Sherin E. Ismail, Chris B. Agala, Arielle J. Perez
Department of Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Background: As the opioid crisis continues to be an important driver of mortality in the United States, the role of surgical prescribing as an early and ongoing contributor to this epidemic requires examination. While a range of local opioid stewardship programs have shown success in reducing post-operative prescribing, the national impact, particularly within general surgery, remains underexplored. Prescribing practices for inguinal hernia repair, a procedure at the forefront of opioid-sparing innovations, has not been studied nationally since 2012, despite being one of the most common surgical interventions. This study addresses this gap, identifying trends in postoperative opioid prescriptions for inguinal hernia repair over the period 2010-2021.
Methods: Using MarketScan, a national insurance claims database, we analyzed the demographics and proportion receiving postoperative opioid prescriptions for patients undergoing ambulatory inguinal hernia repairs from 2010 to 2021.
Results: We identified 190,796 patients of whom 108,983 (57.1%) and 81,813 (42.9%) had open and laparoscopic hernia repair respectively. The median age of our cohort was 52; 177,070 (92.8%) were males. We observed an increase in the proportion prescribed opioids post-operatively over time (47.0% in 2010 vs 70.2% in 2021).
Conclusion: Our findings provide a comprehensive national overview of opioid prescribing trends in inguinal hernia repair and raise questions about the efficacy and reach of opioid stewardship efforts since the opioid crisis has become a focus of the surgical community. Further analyses of this data will examine differences in opioid prescribing trends by operative approach, and test whether this upward trend is also reflected in long-term opioid use outcomes in this patient population.
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