Society of American Gastrointestinal and Endoscopic Surgeons

View all recommendations from this society

Released January 9, 2018; Updated January 19, 2022.

Avoid opioid-only modalities for post-operative pain control.

Opioid overdose has become one of the leading causes of injury related death in the United States and can be linked to the rising rates of opioid prescriptions. Many surgical patients report unused opioid prescriptions following surgery and there is a growing call for better standardization of opioid prescribing practices. Surgeons should utilize additional strategies such as locoregional anesthetic blocks and non-opioid medications (acetaminophen, NSAIDS and others) for pain management where possible.

These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The SAGES Quality, Outcomes and Safety (QOS) Committee appointed a task force (composed of active members of the committee) to develop a list of potential recommendations after being provided with information and links to the Choosing Wisely® website. This group compiled a list of recommendations which fit the criteria outlined by the ABIM Foundation. A literature search was performed to ensure the recommendations were evidence-based. The task force then distributed the list to the full membership of the SAGES QOS Committee, asking the members of the committee to rank the recommendations by level of importance and clinical relevance. The top recommendations were discussed by the committee and selected for inclusion in this list. The list was reviewed and approved by the SAGES Executive Committee and SAGES Board of Governors.


Bicket, M.C. et al., 2017. Prescription Opioid Analgesics Commonly Unused After Surgery: A Systematic Review. JAMA surgery, 152(11), pp.1066–1071.

Dart, R.C., Severtson, S.G. & Bucher-Bartelson, B., 2015. Trends in opioid analgesic abuse and mortality in the United States. The New England Journal of Medicine, 372(16), pp.1573–1574..

Derry, C.J., Derry, S. & Moore, R.A., 2013. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane database of systematic reviews (Online), (6), p.CD010210.

Hill, M.V. et al., 2017. Guideline for Discharge Opioid Prescriptions after Inpatient General Surgical Procedures. Journal of the American College of Surgeons.