One shot to control Pain: Decreasing postoperative opioid use in gynecologic oncology patients with intrathecal opioid injection
| Autor: | Mohamed Nour, Wei Yun Wang, Yevgeniya Ioffe, Linda Hong, Eileen Hou, Ruofan Yao, Michelle Wheeler |
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| Rok vydání: | 2021 |
| Předmět: |
Research Report
Exploratory laparotomy medicine.medical_treatment Gynecologic oncology Intrathecal digestive system Postoperative pain Medicine RC254-282 Univariate analysis business.industry Opioid use Neoplasms. Tumors. Oncology. Including cancer and carcinogens Obstetrics and Gynecology Gynecology and obstetrics Oncology Opioid Anesthesia RG1-991 Morphine business Intrathecal opioid Abdominal surgery medicine.drug |
| Zdroj: | Gynecologic Oncology Reports Gynecologic Oncology Reports, Vol 38, Iss, Pp 100858-(2021) |
| ISSN: | 2352-5789 |
| Popis: | Highlights • - ITO administration was associated with significantly lower IV opioid requirement for the first 12 h following surgery. • - Pain scores were similar between the patients in the ITO and non-ITO groups. • - Patients in the ITO group had increased length of stay of 1 day, compared with the non-ITO group. • - The total overall postoperative opioid requirements were similar in the ITO and non-ITO groups. Objectives To determine whether regional anesthesia with single-shot intrathecal opioid injections (ITO) reduce postoperative pain and intravenous (IV) opioid use after exploratory laparotomy in major gynecologic surgeries. Methods A retrospective chart review of 315 consecutive cases of patients who underwent an exploratory laparotomy on the gynecologic oncology service from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. Longitudinal regression analyses were performed to estimate the effect of ITO on changes in outcomes of interest over time, adjusting for potential confounders. Results 35% (110/315) received ITO preoperatively. There were no differences in patient age, BMI, previous number of abdominal surgeries, history of opioid dependence, type of gynecologic surgery, or total EBL between the ITO and control groups. Preoperative ITO was associated with a significantly lower IV opioid requirement between 0 and 6 hours after surgery (9.7 ± 8.1 vs 14.3 ± 11.5, p |
| Databáze: | OpenAIRE |
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