For a study, researchers sought to determine if patients who have a minimally invasive colectomy consume fewer opioids than those who have an open colectomy. After surgery, opioids were overprescribed, and surgeons were under increasing pressure to minimize opioid prescribing. Minimally invasive colorectal surgery was partly justified by lower inpatient opioid use, but no research has compared post-discharge opioid consumption between minimally invasive and open colectomy. The Collaborative database was used to conduct a retrospective observational study of adult patients who had a colectomy between January 2017 and May 2018. Patients were contacted by phone or email after postoperative day 30 and asked to disclose post-discharge opioid intake. The key outcome measure was post-discharge opioid intake, and the surgical method was the primary predictor (minimally invasive vs open). Investigators utilized a zero-inflated negative binomial regression analysis to find a link between surgical methods and painkiller intake. They found 562 patients from 43 hospitals who had a minimally invasive or open colectomy. After multivariable correction, there was no significant difference between patients who had a minimally invasive versus an open colectomy in terms of opioid intake (P=0.54) or the chance of not using opioids (P=0.39). More opioid use and a lower likelihood of not using opioids were linked to larger prescriptions. Less opioid use was linked to being over 65 and having cancer/adenoma diagnosis. After discharge, patients who have had a minimally invasive or an open colectomy drink the same quantity of opioids. In determining opioid use, the size of the postoperative prescription, the patient’s age, and the diagnosis were more critical factors. Understanding the characteristics that influence postoperative opioid requirements may help surgeons better tailor prescriptions to the needs of their patients.

 

Source:journals.lww.com/annalsofsurgery/Abstract/2022/04000/Post_discharge_Opioid_Consumption_After_Minimally.20.aspx