Abstract:
:Excessive opioid use and misuse is a pervasive and growing societal problem, and decreasing the surgical contribution to this epidemic represents an opportunity to improve outcomes. Here we describe patterns of opioid prescription, consumption, and persistent use among women undergoing minimally invasive hysterectomy (MIH) for benign indications. We performed a systematic review of English full-text articles addressing opioids and gynecologic surgery using MEDLINE and Cochrane Central Register of Controlled Trials according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Additional studies were identified by examination of references. Studies were restricted to randomized controlled, cohort, and observational studies reporting primary data on opioid consumption, prescribing patterns, or risk of persistent use surrounding MIH for benign indications. A risk of bias assessment was performed. Twenty-one studies reported on the 3 outcomes of interest. Median opioid consumption after MIH ranged from 14 to 74 oral morphine equivalents (OMEs) in the first 24 hours and from 50 to 100 OMEs over the first 2 postoperative weeks. Physicians prescribed 125 to 300 OMEs after MIH. Persistent opioid use was identified in 1.5% of women undergoing MIH. In a population at risk for persistent opioid use, prescription often exceeds patients' needs. Guidelines for opioid prescribing in the setting of multimodal anesthetic regimens may allow us to lessen our contribution to the opioid epidemic. Further research on patients with chronic pain, patients with chronic opioid use, and the role of patient education is needed.
journal_name
J Minim Invasive Gynecoljournal_title
Journal of minimally invasive gynecologyauthors
Johnson CM,Makai GEHdoi
10.1016/j.jmig.2018.08.024subject
Has Abstractpub_date
2019-02-01 00:00:00pages
233-243issue
2eissn
1553-4650issn
1553-4669pii
S1553-4650(18)30443-6journal_volume
26pub_type
杂志文章abstract::The pelvic uterus-like mass is a rare phenomenon in which an extrauterine mass, comprised of smooth muscle and a central cavity lined by endometrium, is found within the pelvis. The mass is associated with endometriosis and in some of the cases with congenital Müllerian malformations. There is an ongoing debate whethe...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.03.002
更新日期:2008-07-01 00:00:00
abstract:STUDY OBJECTIVE:The aim of our study was to determine if laparoscopic radical hysterectomy (LRH) can be routinely used for the treatment of early-stage cervical cancer. DESIGN:From May 2008, LRH was planned for all primarily operable cervical cancer patients after receiving informed consent in our department. The surg...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2014.09.009
更新日期:2015-02-01 00:00:00
abstract:STUDY OBJECTIVE:The identification of less invasive methods with acceptable diagnostic value for evaluating intrauterine abnormalities can improve the satisfaction of patients and physicians. Although hysteroscopy plus biopsy has favorable predictive and diagnostic values, limited studies have evaluated its value, and ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.02.016
更新日期:2020-01-01 00:00:00
abstract::The literature was searched for endometriosis and hysterectomy on PubMed and the individual search engines of the Journal of Minimally Invasive Surgery, Fertility and Sterility, BJOG, Obstetrics and Gynecology, the American Journal of Obstetrics and Gynecology, and Human Reproduction. Eighty references of interest wer...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2006.06.022
更新日期:2006-11-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the effects of peritoneal cold nebulization of ropivacaine on pain control after gynecologic laparoscopy. DESIGN:Evidence obtained from a properly designed, randomized, double-blind, placebo-controlled trial (Canadian Task Force classification I). SETTING:Tertiary care center. PATIENTS:On...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2014.03.021
更新日期:2014-09-01 00:00:00
abstract:STUDY OBJECTIVE:To provide surgeons with techniques for preemptive analgesia during minimally invasive gynecologic surgery. Postoperative pain management is an important component of patient care after gynecologic surgery. There have been numerous advances in pain management, including studies that show that preoperati...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.09.768
更新日期:2019-02-01 00:00:00
abstract::The radio-guided occult lesion localization (ROLL) technique has been in use since the mid-1990s, mainly in breast surgery. Today, ROLL is used for numerous oncologic pathologies, including parathyroid lesions, melanomas, and colorectal tumors. We report a patient with an 11-mm left mesorectal solitary recurrence of a...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2016.09.012
更新日期:2017-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the safety and efficacy of cold loop hysteroscopic myomectomy in a large series of cases. DESIGN:Retrospective study (Canadian Task Force Classification III). SETTING:Arbor Vitae Center for Endoscopic Gynecology, Rome, Italy. PATIENTS:A total of 1215 patients with 1 or more G1-G2 submucous ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.03.004
更新日期:2015-07-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the feasibility and safety of a McCall culdoplasty at the time of total laparoscopic hysterectomy and to evaluate the differences in the total vaginal length, vaginal apex during Valsalva, and sexual function 12 months after McCall culdoplasty compared with standard cuff closure. DESIGN:A pil...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2017.10.036
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the feasibility of a noncontact radio sensor as an objective measurement tool to study postoperative recovery from endometriosis surgery. DESIGN:Prospective cohort pilot study. SETTING:Center for minimally invasive gynecologic surgery at an academically affiliated community hospital in conju...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.06.011
更新日期:2020-06-29 00:00:00
abstract:STUDY OBJECTIVE:To determine patient and hospital characteristics that were associated with undergoing laparoscopic hysterectomy compared with abdominal hysterectomy. DESIGN:Canadian Task Force Classification II-3. METHODS:In this retrospective cohort study, we analyzed the 2010 Healthcare Cost and Utilization Projec...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2013.08.709
更新日期:2014-03-01 00:00:00
abstract:STUDY OBJECTIVE:To compare the effects of the laparoscopic approach versus the vaginal route for the management of vaginal cuff closure during total laparoscopic hysterectomy on female sexual function in premenopausal patients with benign gynecologic conditions. DESIGN:A prospective study with a randomized, double-bli...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jmig.2016.07.007
更新日期:2016-09-01 00:00:00
abstract::Hemangiomas are known to be common benign tumors. However, hemangiomas of female genital organs are very rare. Furthermore, a retroperitoneal hemangioma arising from ovarian vessels has never been reported. Here we report a case of a 29-year-old woman with a retroperitoneal cavernous hemangioma arising from the ovaria...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.07.017
更新日期:2009-11-01 00:00:00
abstract::Female reproductive tract anomalies are difficult to number in the general population but are often discovered in evaluations of menstrual complications or fertility disorders. Traditionally, assessment of the reproductive tract entailed hysterosalpingography to image the uterine cavity with the final diagnosis provid...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2013.10.014
更新日期:2014-05-01 00:00:00
abstract::The popularity of laparoscopy to perform radical hysterectomy has massively increased over the last 2 decades. However, oncologic outcomes (overall and disease-free survival) have been found to be better in patients managed by laparotomy compared with laparoscopy, challenging this surgical route. Compared with laparot...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.06.004
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To illustrate the laparoscopic surgical management of a particular localization of extrauterine pregnancy misdiagnosed until 12 weeks gestational age, complicated by hemoperitoneum and abortion. DESIGN:Canadian Task Force III on the Periodic Health Examination's Levels of Evidence. SETTING:The prevalence of...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2017.01.023
更新日期:2017-01-01 00:00:00
abstract::Bleeding in adolescence is a common but, potentially, difficult condition to manage. Adolescents present with unique issues related to their age, involvement of family members, different differential diagnosis when compared to an older populations, and challenges associated with their evaluation and treatment. ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.08.014
更新日期:2008-11-01 00:00:00
abstract:STUDY OBJECTIVE:Our primary goal was to uncover preoperative and intraoperative risk factors that prevented same-day discharge (SDD) after myomectomy in a setting where SDD was the standard of care. Uncovered predictors would serve to enhance patient counseling and medical optimization before surgery. DESIGN:Single-ce...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2019.03.022
更新日期:2020-01-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate rates of urologic injury in patients who underwent robotic hysterectomy compared with laparoscopic, vaginal, and open hysterectomy. DESIGN:A retrospective analysis (Canadian Task Force classification II-2). SETTING:Henry Ford Health System, 2013 to 2016. PATIENTS:Women who underwent robot...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2018.01.004
更新日期:2018-01-01 00:00:00
abstract:STUDY OBJECTIVE:To present a series of robotic laparoendoscopic single-site surgery (LESS) and reduced-port hysterectomy cases and discuss the surgical technique required for successful use on this new platform. DESIGN:Retrospective case series. SETTING:Academic medical center. PATIENTS:All patients undergoing robot...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2020.08.009
更新日期:2020-08-20 00:00:00
abstract:STUDY OBJECTIVE:To evaluate the safety and short-term outcomes of laparoscopic subtotal hysterectomy using the PK and Lap Loop systems. DESIGN:Prospective observational study (Canadian Task Force classification II-2). SETTING:Princess Royal University and Chelsfield Park Hospitals, Kent, UK. PATIENTS:One hundred wom...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2005.05.007
更新日期:2005-07-01 00:00:00
abstract:STUDY OBJECTIVE:Because of the rapid growth of minimally invasive surgical procedures, we developed an ultrathin fiberscopic imaging system for laser surgery that could be an important instrument for clinical use in an office setting. METHODS AND MAIN RESULTS:A new device, consisting of a custom 1.1-mm diameter flexib...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2015.04.024
更新日期:2015-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the efficacy and reproductive outcome of hysteroscopic removal of retained products of conception. DESIGN:Retrospective analysis (Canadian Task Force classification II-3). SETTING:Tertiary care university hospital. PATIENTS:One hundred fifty-nine patients were consecutively admitted to our ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2010.09.001
更新日期:2011-01-01 00:00:00
abstract::Uterine inversion is a rare obstetric emergency usually occurring in the immediate postpartum period after the third stage of labor. The incidence is reported to be between 1 in 550 to 1 in several thousand deliveries. Delayed postpartum uterine inversion is even less common, and may present a management challenge. We...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2009.12.003
更新日期:2010-03-01 00:00:00
abstract:STUDY OBJECTIVE:To assess whether it is possible for an experienced laparoscopic surgeon to perform efficient laparoscopic myomectomy regardless of the size, number, and location of the myomas. DESIGN:Prospective observational study (Canadian Task Force classification II-1). SETTING:Tertiary endoscopy center. PATIEN...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2008.01.009
更新日期:2008-05-01 00:00:00
abstract:STUDY OBJECTIVE:To estimate the concentration of natural killer (NK) cells in the peripheral blood in patients with and without endometriosis. DESIGN:Case-control study (Canadian Task Force classification II-2). SETTING:Tertiary referral hospital. PATIENTS:One hundred fifty-five patients who had undergone videolapar...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2011.12.021
更新日期:2012-05-01 00:00:00
abstract::Prolapse of a sigmoid neovagina, created in patients with congenital vaginal aplasia, is rare. In correcting this condition, preservation of coital function and restoration of the vaginal axis should be of primary interest. A 34-year-old woman with vaginal agenesis underwent vaginoplasty using sigmoid colon. Almost 6 ...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章,评审
doi:10.1016/j.jmig.2011.12.012
更新日期:2012-03-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether transvaginal hysterosalpingo-contrast sonography (HyCoSy) with a new dedicated contrast-enhanced ultrasound technique, can contribute to accurate diagnosis of tubal occlusion. DESIGN:Prospective observational study (Canadian Task Force classification II-2). SETTING:University hosp...
journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jmig.2009.03.019
更新日期:2009-07-01 00:00:00
abstract::Herein is described the case of a 28-year-old woman in whom uterine artery embolization (UAE) was performed to treat intramural ectopic pregnancy. The intramural ectopic pregnancy was diagnosed at magnetic resonance imaging, which showed a gestational sac surrounded completely by myometrium. The UAE procedure was unco...
journal_title:Journal of minimally invasive gynecology
pub_type: 杂志文章
doi:10.1016/j.jmig.2012.10.005
更新日期:2013-03-01 00:00:00
abstract:STUDY OBJECTIVE:To describe the feasibility of performing Essure hysteroscopic sterilization immediately after NovaSure global endometrial ablation (GEA). DESIGN:Descriptive feasibility study (Canadian Task Force classification III). SETTING:Midwestern United States academic medical center. PATIENTS:Twenty-five wome...
journal_title:Journal of minimally invasive gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jmig.2007.01.014
更新日期:2007-07-01 00:00:00