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Characteristics of opioid users undergoing surgery for pelvic organ prolapse.

Abstract：

INTRODUCTION AND HYPOTHESIS:Understanding demographic and opioid utilization patterns of preoperative opioid users compared with opioid-naïve patients undergoing surgical treatment for pelvic organ prolapse (POP) better informs opioid prescribing. METHODS:A cohort of preoperative opioid users undergoing surgery for POP from 1 January 2012 through 30 May 2017 was identified. Electronic medical records were utilized to obtain pain scores and prescription data. The cohort was organized by surgical approach, number of concomitant procedures, and patient age. These factors were then matched to pain scores, opioid quantity prescribed at discharge, and subsequent refills. Pain scores and opioid use were evaluated for correlation. Results were then compared with similar data previously published for opioid-naïve patients undergoing surgical treatment of POP. RESULTS:Preoperative opioid users were younger (55.5 [14.7] vs 59.5 [12.7]; p = 0.002), of higher body mass index (BMI; 29.2 [5.4] vs 28.6 [10.3]; p = 0.04), and less likely Caucasian (90.3% vs 95.9%; p = 0.002) than opioid-naïve patients. After matching for these differences, opioid users reported higher pain scores (3.5 [2.2] vs 2.6 [1.8]; p = <0.0001), but received similar opioid quantities (324.4 [395] vs 296 [158] oral morphine equivalents [OME]; p = 0.27; 16.8% vs 10.4% refill rates; p = 0.07). In preoperative opioid users, neither surgical approach nor the number of concomitant procedures influenced pain scores. Increasing mean pain scores (1.8 [2.0] to 4.2 [2.4]; p < 0.002) and OME prescribed (226 [170.2] to 541 [902.5] p = 0.056; 0% to 22.2% refill rates; p = 0.02), were seen with decreasing patient age. Pain scores correlated directly with the opioid amount prescribed. CONCLUSIONS:Patient age and preoperative opioid utilization should be factored into urogynecological postoperative opioid-prescribing protocols.

journal_name

Int Urogynecol J

journal_title

International urogynecology journal

authors

Leach DA,Scarlotta LS,Habermann EB,Glasgow AE,Occhino JA

doi

10.1007/s00192-019-04215-1

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

1891-1897

issue

eissn

0937-3462

issn

1433-3023

pii

10.1007/s00192-019-04215-1

journal_volume

pub_type

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Characteristics of opioid users undergoing surgery for pelvic organ prolapse.