Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis.

Autor: Diaz S; Department of Surgery, St Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA., Brockhaus KK; Department of Pharmacy, St Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA., Bobel MC; Department of Surgery, St Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA., Colom SM; Methods Consultants, Ypsilanti, MI, USA., Ramm C; Department of Academic Research, St Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA., Cleary RK; Department of Surgery, St Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA. Electronic address: Robert.Cleary@trinity-health.org.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2024 Jun; Vol. 232, pp. 131-137. Date of Electronic Publication: 2024 Feb 08.
DOI: 10.1016/j.amjsurg.2024.01.034
Abstrakt: Background: Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive.
Methods: Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge.
Results: 641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly higher NPS for the Benign than the Malignant group preoperative and postoperative day 0 (after surgery), 1, 2, and 3 (all p ​≤ ​0.001). Opioids prescribed at discharge were significantly higher in the Benign group (60.0% vs 51.1%, p ​= ​0.018). After regression analysis, there was no longer a significant difference in NPS (B ​= ​0.703, p ​= ​0.095) and opioids prescribed between groups [OR ​= ​0.803 (95%CI 0.586, 1.1), p ​= ​0.173].
Conclusions: Pain and opioids prescribed at discharge are not significantly different between benign and malignant diseases in an enhanced recovery pain management pathway that maximizes non-opioid multimodal analgesic strategies.
Competing Interests: Declaration of competing interest Sarah E Diaz DO has no conflict of interest or financial ties to disclose. Kara K Brockhaus PharmD has no conflict of interest or financial ties to disclose. Matthew C Bobel MD no conflict of interest or financial ties to disclose. Sara Colom MS no conflict of interest or financial ties to disclose. Carole Ramm MS no conflict of interest or financial ties to disclose. Robert K Cleary MD has received honoraria from Intuitive Surgical, Inc. for educational speaking.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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