Narcotic-Dependent Patients Derive Equal Benefit from Enhanced Recovery

Area of Science:

• Colorectal Surgery
• Enhanced Recovery Protocols
• Opioid Use and Abuse

Background:

• Southeast US faces high rates of prescription drug misuse.
• Preoperative narcotic use is linked to worse surgical outcomes and readmissions.
• Need to evaluate outcomes for patients on preoperative opioids.

Purpose of the Study:

• To determine health outcomes of preoperative narcotic users undergoing colorectal surgery.
• To assess outcomes within the enhanced recovery (ER) protocol.
• Compare opioid-dependent vs. opioid-naïve patients.

Main Methods:

• Study included 505 colorectal surgery patients in an ER protocol.
• Opioid dependence defined as 30-day active prescription prior to surgery.
• Outcomes assessed using National Surgical Quality Improvement Program variables (30-day readmission, reoperation, length of stay).

Main Results:

• 101 patients were opioid-dependent; 404 were opioid-naïve.
• Groups were comparable in age, BMI, and physical classification.
• No significant differences in readmission, reoperation, or length of stay between groups.

Conclusions:

• Opioid-dependent patients in the ER protocol showed comparable outcomes to opioid-naïve patients.
• Preliminary data suggest ER protocols benefit opioid-dependent patients.
• Further research warranted to confirm findings in larger cohorts.