E-Posters-10222

10222_Shah

Pdf Summary

This study aimed to determine the optimal outpatient opioid requirements for patients undergoing minimally invasive pelvic reconstructive surgery. The researchers conducted a secondary analysis of a randomized controlled trial that examined the effect of therapeutic suggestion in patients undergoing transvaginal hysterectomy with minimally invasive sacrocolpopexy. A subset of patients recorded all outpatient medication usage, which included opioids. The opioids used were converted into morphine milligram equivalents (MME) for standardization. The MMEs used were analyzed to determine the optimal outpatient opioid requirements.<br /><br />The study included 26 out of 32 participants from the original trial. Most subjects were Caucasian, with a median age of 57 years. The majority had stage 2 uterovaginal prolapse. Concomitant procedures were also performed in some subjects, such as salpingectomy, midurethral sling placement, and posterior repair. The overall pain medication usage was low, with 26.9% of participants not requiring opioid pain medications in the outpatient setting. Subjects used only a small portion of the opioid pills prescribed, with a median of 10% used. The median MME required for adequate pain control was 25.2mg.<br /><br />The researchers concluded that most patients use only a small fraction of the opioids prescribed after minimally invasive pelvic reconstructive surgery. They recommend reducing the number of opioid tablets prescribed after surgery to a total quantity of 67.2 MME (equivalent to 8-14 tablets of commonly prescribed opioids). The study emphasizes the need for responsible opioid prescribing while ensuring adequate pain control. The findings suggest that the majority of patients will receive adequate pain control with this reduced quantity of opioids. However, further evaluation may be needed for a small subset of patients who require additional medications.

Keywords

outpatient opioid requirements

minimally invasive pelvic reconstructive surgery

therapeutic suggestion

transvaginal hysterectomy

minimally invasive sacrocolpopexy

medication usage

morphine milligram equivalents

pain medication usage

uterovaginal prolapse

responsible opioid prescribing