For a study, researchers sought to determine if a patient education program and multimodal opioid-limiting regimen may lower postoperative opioid consumption after transurethral prostate surgery.

In the prospective, non-blinded, single-institution, randomized controlled study, 50 patients undergoing transurethral prostate resection were randomly allocated to either the multimodal experimental group (MMG) or the standard of care control (SOC). The intervention comprised discharge without an opioid prescription, encouraging prudent opioid usage while inpatient, an educational intervention, and ibuprofen in addition to the postoperative pain regimen. Comparisons were made between demographic, procedural, opioid, pain, and patient satisfaction data.

There were 47 patients altogether, including n=23 (MMG) and n= 24 (SOC). Both the demographic and operational results were comparable. The statistical analysis results for noninferiority showed that inpatient pain control was non-inferior (mean pain score 2.5 MMG vs. 2.4 SOC, P=0.0003). After discharge, the multimodal group utilized noticeably fewer morphine milligram equivalents (0 vs. 4.1, P=0.04). Although inpatient utilization decreased, it did not show a statistically significant reduction (6.0 vs. 9.8, P=0.2). The average ratings for pain control satisfaction were comparable (9.6 MMG vs. 9.2 SOC, P=0.32). After discharge, no requests for opioid prescriptions were made. Unfavorable outcomes and drug side effects were uncommon and basically comparable between groups.

Patient education and an opioid-restrictive postoperative pain strategy prevented outpatient opioid usage while preserving patient satisfaction with pain management. The likelihood of opioid-related adverse events will be reduced, and there will be a beneficial knock-on effect if opioids are eliminated after a common urologic operation.

Reference: goldjournal.net/article/S0090-4295(22)00241-2/fulltext