Choosing the unit of measurement counts: The use of oral morphine equivalents in studies of opioid consumption is a useful addition to defined daily doses

Svendsen, Kristian; Borchgrevink, Petter Chr.; Fredheim, Olav Magnus S.; Hamunen, Katri; Mellbye, A.; Dale, Ola

doi:10.1177/0269216311398300

Cited by 179 publications

(167 citation statements)

References 18 publications

(45 reference statements)

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“…We calculated the total amount of oral morphine equivalents that each patient used between midnight and midnight on the day of enrollment with the following conversion with 30 oral morphine equivalents equivalent to 10 mg intravenous morphine sulfate; 1.5 mg intravenous hydromorphone; 7.5 mg oral hydromorphone; 20 mg oral oxycodone; 30 mg oral hydrocodone; and 150 mg oral tramadol [20,30,33].…”

Section: Methodsmentioning

confidence: 99%

Opioid Use After Fracture Surgery Correlates With Pain Intensity and Satisfaction With Pain Relief

Bot

Bekkers

Arnstein

et al. 2014

Clinical Orthopaedics &Amp; Related Research

158

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Background In 2012, Medicare began to tie reimbursements to inpatient complications, unplanned readmissions, and patient satisfaction, including satisfaction with pain management. Questions/purposes We aimed to identify factors that correlate with (1) pain intensity during a 24-hour period after surgery; (2) less than complete satisfaction with pain control; (3) less than complete satisfaction with staff attention to pain relief while in the hospital; and we also wished (4) to compare inpatient and discharge satisfaction scores. Methods Ninety-seven inpatients completed measures of pain intensity (numeric rating scale), satisfaction with pain relief, self-efficacy when in pain, and symptoms of depression days after operative fracture repair. The amount of opioid used in oral morphine equivalents taken during the prior 24 hours was calculated. Through initial bivariate One of the authors (AGJB) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period from ''AnnaFonds Travel grant'' (Dutch Orthopaedic travel grant), Leiden, the Netherlands (less than USD 10,000); ''VSBfonds'', Utrecht, the Netherlands, a nonmedical study grant (less than USD 10,000); and ''Prins Bernhard Cultuurfonds, Banning-de Jong fonds'', Amsterdam, the Netherlands, a nonmedical study grant (less than USD 10,000). One of the authors (SB) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period, an amount of less than 10,000 USD from a VU University ''Faculty Fund'', Amsterdam, the Netherlands. One of the authors (PMA) has received funding from Connell Nursing Research Scholarship (less than USD 10,000); the Nurse Practitioner Healthcare Foundation (less than USD 10,000); the American Pain Society and the American Association of Nurse Practitioners (less than USD 10,000); the Nurse Practitioner Healthcare Foundation (less than USD 10,000); and F.D. Davis Publishers (less than USD 10,000). One of the authors (DR) certifies that he, or a member of his immediate family, has or may receive payments or benefits, during the study period from a study-specific grant from Skeletal Dynamics (USD 10,000-100,000) (Miami, FL, USA); is a consultant for Wright Medical (Memphis, TN, USA), Skeletal Dynamics, and Biomet (Warsaw, IN, USA) (less than USD 10,000); received honoraria from AO North America (Paoli, PA, USA), and AO International (less than USD 10,000); and received royalties from Wright Medical (less than USD 10,000). All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained. and then multivariate analysis, we identified factors that we...

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Section: Methodsmentioning

confidence: 99%

Opioid Use After Fracture Surgery Correlates With Pain Intensity and Satisfaction With Pain Relief

Bot

Bekkers

Arnstein

et al. 2014

Clinical Orthopaedics &Amp; Related Research

158

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“…OMEQ means equivalent dosages of strong opioids (administered through oral, parenteral, or transdermal routes) relative to analgesic strength of oral morphine. 22,23 OMEQ conversion factors used were as follows: 1.0 for morphine oral intake, 3 for morphine intravenous or intramuscular injection, 0.25 for codeine intramuscular injection, 0.15 for codeine oral intake, 3.0 for fentanyl transdermal route (from mcg/hr to mg/day), 0.4 for meperidine intravenous or intramuscular injection, 0.1 for meperidine oral intake, and 40 for buprenorphine sublingual use. 22 Average OMEQ per ambulatory visit was presented as medians with the 25 th and 75 th quartiles (Q1 and Q3).…”

Section: Methodsmentioning

confidence: 99%

Pharmacoepidemiology of chronic noncancer pain patients requiring chronic opioid therapy: A nationwide population-based study

Chang

Lee

et al. 2015

Acta Anaesthesiologica Taiwanica

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“…The total dose of intraoperative opioids was recorded and converted to oral morphine equivalents (OMEQs) using standard equianalgesic conversion tables [11][12][13][14]. Postoperative opioid consumption for the first 24 hours after surgery was also collected and converted to OMEQs.…”

Section: Methodsmentioning

confidence: 99%

Effect of preoperative gabapentin and acetaminophen on opioid consumption in video-assisted thoracoscopic surgery: a retrospective study

Qiu

Perrino

Zurich

et al. 2018

Rom J Anaesth Int Care

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Background: Patients undergoing video-assisted thoracoscopic surgery (VATS) are particularly vulnerable to opioid-induced sedation and hypoventilation. Accordingly, reducing opioid consumption in these patients is a primary goal of multimodal analgesic regimens. Although administration of preoperative gabapentin and acetaminophen has been shown to decrease postoperative opioid consumption in other surgeries, this approach has not been studied in VATS lobectomy. Our objective was to examine the impact of the addition of preoperative gabapentin and acetaminophen to a VATS lobectomy multimodal analgesic plan on postoperative opioid consumption, nausea/vomiting, and sedation.Methods: With IRB approval, we performed a retrospective chart review of patients who underwent VATS lobectomy at a single center between 2015 and 2016 to identify those that received preoperative gabapentin and acetaminophen and those that received neither. Opioid consumption in the first 24 hours postoperatively was converted to oral morphine equivalents (OMEQs). Postoperative sedation was evaluated using Aldrete scores and the percentage of patients requiring antiemetics in the first 24 hours was also examined.Results: There were 133 patients who were opioid naive: 31 received preoperative gabapentin and acetaminophen and 102 received neither. Median 24 hour postoperative opioid consumption was lower but not statistically significant in the gabapentin and acetaminophen group vs. neither (36 mg vs. 45 mg, p = 0.08). Notably, there was a change in the distribution of opioid consumption, with no patients in the gabapentin and acetaminophen group requiring more than 200 mg OMEQ in the first 24 hours postoperatively. No significant difference in postoperative nausea/vomiting or sedation was observed.Conclusions: The addition of preoperative gabapentin and acetaminophen to a VATS lobectomy multimodal analgesic regimen reduces the incidence of high dose postoperative opioid consumption without observed negative side effects.

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Choosing the unit of measurement counts: The use of oral morphine equivalents in studies of opioid consumption is a useful addition to defined daily doses

Abstract: OMEQ reflects clinical dosing better than DDD, and can give additional insight into opioid consumption when combined with DDD. Using OMEQ can also lead to different conclusions in opioid consumption studies compared with using DDD alone.

Cited by 179 publications

References 18 publications

Opioid Use After Fracture Surgery Correlates With Pain Intensity and Satisfaction With Pain Relief

Opioid Use After Fracture Surgery Correlates With Pain Intensity and Satisfaction With Pain Relief

Pharmacoepidemiology of chronic noncancer pain patients requiring chronic opioid therapy: A nationwide population-based study

Effect of preoperative gabapentin and acetaminophen on opioid consumption in video-assisted thoracoscopic surgery: a retrospective study

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