P71. Low dose versus high dose opioid prescriptions in addition to non-opiate analgesics in opioid naïve patients undergoing spine surgery

BACKGROUND CONTEXT Medically prescribed opiates contribute to the opioid crisis, manifesting in significant mortality and economic burden. While opioids are a mainstay of pain amelioration, prescription practices among surgeons are heterogenous. This study sought to investigate the relationship between immediate postoperative opioid prescriptions and patient reported pain outcomes following spinal surgery. PURPOSE To investigate the relationship between immediate postoperative opioid prescriptions and patient reported pain outcomes at POD 30 following spinal surgery. STUDY DESIGN/SETTING Patients undergoing spine surgery from 2012-2018 at a tertiary care referral facility. The prescribed opioid dose was converted to morphine milligram equivalents (MME) per day using a standard reference table. Nonsteroidal anti-inflammatory drug (NSAID) or Acetaminophen regimen was classified as either low dose or high dose non-opiate analgesics based on the median doses currently prescribed. PATIENT SAMPLE Inclusion criteria included: (1) patients who had clinical follow-up with preoperative (preop), POD 1, and POD 25-35 (referred to as POD 30) pain scores reported on the visual analog scale (VAS); (2) patients who were discharged from the hospital in good health. A total of 1,428 patients met inclusion criteria. OUTCOME MEASURES (1) Postoperative day 30 (POD30) visual analog scale (VAS) pain score; (2) 50% reduction in patient reported pain score between preop and POD 30. METHODS Patients with previous history of opioid usage or those receiving treatment for malignancy, trauma, or infection were excluded. Patient reported pain outcomes at preoperative and various postoperative days were measured using the visual analog scale. Chi-square, Kruskal-Wallis, linear, and logistic regression were used to investigate associations between covariates and postoperative pain scores. RESULTS Results of our univariate and multivariable linear regression found a patient POD 1 VAS to be associated with POD 30 VAS scores (P CONCLUSIONS Our study found that patients receiving the lowest dosage of opioid prescriptions ( FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.