Introduction/Background Medical prescriptions contribute to the opioid crisis. Recent literature suggests opioids’ discharge prescriptions should be personalised based on patients’ opioid consumption during the last 24h of hospitalisation. Enhanced Recovery After Surgery (ERAS) guidelines recommend multimodal analgesia approach and limited opioid prescription. This study compares the opioid discharge prescription to last 24h consumption in endometrial cancer patients.

Methodology A retrospective cohort study was conducted and included endometrial cancer patients undergoing hysterectomy under ERAS protocol in 2019 at Centre hospitalier de l’Université de Montréal(CHUM). Exclusion criteria were patients with sarcoma, chronic opioid use, same-day discharge. As a significant number of patients undergoing primary surgery for endometrial cancer spend less than 24h at the hospital, post operative opioid and co-analgesia consumption in the last 24h pre discharge was adjusted from the consumption in the last 12h pre discharge. Adjusted 24h opioid and co-analgesia pre discharge consumption was compared with prescription daily posology. Patients were controlled by surgical approach. Statistical significance was 0.05.

Results 186 patients were analysed: 26.34% laparotomy, 41.40% laparoscopy, and 32.26% robotic surgery. Histological types were 76.35% endometrioid adenocarcinoma, 19.35% serous carcinoma, 3.23% clear-cell carcinoma, and 1.08% mixed carcinoma. 89.25% stayed at least 12h at care unit. 94.62% of analgesia logs and 88.17% of prescription logs were available. Last 24h opioid consumption was 14.80, 11.09, and 10.35 morphine milligram equivalent(MME) and prescription daily posology was 39.53, 34.60, and 29.80 MME respectively for laparotomy, laparoscopy and robotic surgeries. Often prescribed co-analgesia were acetaminophen and naproxen. Ibuprofen, celecoxib, and ketorolac were also prescribed.

Conclusion The amount of opioid prescribed at discharge were significantly greater than the posology required according to last 24h opioid consumption. Co-analgesia prescription did not meet ERAS guidelines recommendations. Auditing practices is essential for better awareness. Education and standardisation of opioids’ discharge prescriptions could help control the opioid crises.