Publication date: Available online 2 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Jonathan J. Lopez, Nafisseh S. Warner, Christopher J. Arpey, Christian L. Baum, Jerry D. Brewer, Clark C. Otley, Halena M. Gazelka, Randall K. Roenigk
Abstract
Background
Little information is available to predict which patients require opioid analgesia following cutaneous surgery. When opioids are indicated, information is lacking regarding the optimal opioid agent selection and dosage.
Objective
To make recommendations for opioid prescription after cutaneous surgery.
Methods
A PubMed literature search was conducted to review the available literature. Recommendations are presented on the basis of available evidence and the opinion of the authors.
Results
Most patients undergoing cutaneous surgery do not require opioid analgesia. For those who do, the pain duration warranting opioid analgesia is generally less than 36 hours. Opioid refill requests warrant a follow-up visit to ascertain the cause of ongoing pain after excisional procedures.
Limitations
The recommendations are not based on prospective randomized trials.
Conclusions
The presented recommendations for opioid prescription practice are derived from available evidence, recommendations, and expert opinion.
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