Vascular Surgery
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Carotid Endarterectomy
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DATA ANALYSIS
Carotid Endarterectomy
- Patient Reported Outcomes data collected via Michigan Surgical Quality Collaborative
- January 1, 2018 – October 31, 2021
- 94 Opioid Naive Patients from 19 Michigan Hospitals
SUPPORTING LITERATURE
Balceniuk et al. 2019 (Level 3 evidence)
Gifford et al. 2020 (Level 3 evidence)
- DOI: https://doi.org/10.1016/j.jvs.2019.05.068
- Retrospective review of prescribing patterns following various vascular procedures.
- Overall median MME prescribed across 9 vascular procedures was 0 MME. CEA among the lowest with an individual median of 0 MME.
OPIOID PRESCRIBING
When an opioid is needed after surgery, use the OPEN prescribing recommendations as the foundation for a shared decision-making conversation with the patient to determine the best prescription size.
It’s important to note that these are not rigid rules that must be adhered to, but rather recommendations. Starting form a standardized approach and then allowing for individualization helps promote both equity and patient-centeredness.
- Determine the opioid prescribing range based on:
- Type of procedure
- Additional procedures performed
- With the patient, determine the best prescription size within the appropriate range
- Assess for individual risk factors
- Consider patient preferences and other non-opioid strategies utilized
- Pain management at the time of discharge:
- Pain scores in 24 hours prior to discharge
- Medication use in 24 hours prior to discharge
- Timing of discharge
