To determine the impact of transitioning from opioid to non-opioid analgesia post-vasectomy on unplanned opioid prescriptions and health encounters.
A retrospective review for patients who underwent vasectomy from October 2018 through December 2019 was performed. Beginning February 1, 2019, patients were counseled to take scheduled acetaminophen and ibuprofen in lieu of acetaminophen with codeine, with an opioid prescription only provided upon request. Analysis was performed comparing 200 consecutive patients before and after this transition. Baseline patient characteristics, unplanned post-operative encounters for pain within 30 days of vasectomy, and associated narcotic prescriptions were compared between groups.
400 patients were included, consisting of 200 patients pre and 200 patients post-intervention. There were no differences in socioeconomic characteristics between groups. No differences between the pre- and post-intervention groups were observed in terms of generating telephone calls to clinic (9% vs 11%, p = 0.5), clinic visits (2.5% vs 2.5%, p = 1), or ED visits (0% vs 1%), p = 0.5) for the pre and post intervention cohorts, respectively.
Patients that are not prescribed opioids after vasectomy do not generate additional phone calls, clinic or ED visits compared to those that were routinely prescribed prior to our institutional change. We have permanently discontinued the routine use of opioids for post-vasectomy analgesia. Other physicians performing vasectomy should consider making this change as well.

References

PubMed