Older Women and Opioid Analgesia after Breast Cancer Surgery.
Karen E Alsbrook, Caroline K Harpel, Paul W Scott and 3 others
PMID 33674240WHAT IT FOUND
Most older women after early breast cancer surgery used little or no opioids: 29 of 57 needed none 48 hours after discharge, and mean post-discharge pain was 3.04 out of 10.
Some with pain scores of 7/10 and 10/10 took only one tablet.
Key findings
01Of 57 older women after early-stage breast cancer surgery, 29 required no opioid analgesia in the 48 hours after discharge.
02Mean pain scores were low: 2.98 out of 10 in the post-anesthesia care unit and 3.04 out of 10 at 48 hours after discharge.
03Only the type of opioid taken at 48 hours and the type received in the post-anesthesia care unit predicted the morphine milligram equivalents taken after discharge.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a small secondary analysis of 57 women, and only 28 of them used opioids after discharge, so the regression results rest on a limited group. The study was nonexperimental, so it cannot show that opioid type caused a certain dose. Most participants were White/Caucasian (91.2%), and the sample came from two hospitals with the same surgical team and enhanced recovery protocols, so results may not apply elsewhere. Pain and opioid use after discharge were recalled by telephone two days later, so recall bias may have affected the numbers. The study did not separate opioid tablets taken for acute surgical pain from tablets taken for chronic pain conditions such as osteoarthritis. None of the women received regional anesthesia, so the low opioid use may not apply to patients whose surgical pain is managed differently.
Declared interests
The supplied article type lists Research Support, N.I.H., Extramural. No funding statement or conflict-of-interest declaration appears in the text provided.
The easy way to misread this
Do not conclude that older women routinely need little opioid after breast surgery or that prescriptions can be reduced. The study was small and observational, and two women with pain scores of 7/10 and 10/10 still took only one tablet.