Decreasing postoperative narcotics in reconstructive pelvic surgery: a randomized controlled trial.

Area of Science:

• Surgical Recovery
• Pain Management
• Pharmacology

Background:

• Effective postoperative pain control is essential for patient recovery.
• Current pain management often relies heavily on narcotic medications.

Purpose of the Study:

• To assess the efficacy of a multimodal pain regimen following pelvic reconstructive surgery.
• The study aimed to compare narcotic use and pain levels between standard care and a multimodal approach.

Main Methods:

• Patients were randomized into two groups: usual care or a multimodal pain regimen.
• The multimodal regimen included various medications (celecoxib, gabapentin, acetaminophen, ibuprofen) administered pre-, intra-, and postoperatively.
• Narcotic use was standardized using oral morphine milligram equivalents, with pain assessed via the Brief Pain Inventory survey.

Main Results:

• The multimodal group demonstrated significantly lower intravenous and total narcotic usage compared to the usual care group.
• A higher percentage of patients in the multimodal group used zero oral narcotics post-discharge.
• No significant differences in pain scores, nausea, or bowel function were observed between the groups.

Conclusions:

• A multimodal pain regimen effectively reduces postoperative opioid requirements in pelvic reconstructive surgery.
• This approach achieves comparable pain control to traditional methods while minimizing narcotic dependence.