Opioid-Limiting Pain Control After Transurethral Resection of the Prostate: A Randomized Controlled Trial.

Area of Science:

• Urology
• Pain Management
• Pharmacology

Background:

• Postoperative pain management after transurethral resection of the prostate (TURP) often involves opioids, posing risks of dependence and adverse events.
• There is a need for effective, opioid-sparing strategies to manage pain following common urological procedures.

Purpose of the Study:

• To evaluate the efficacy of a multimodal opioid-limiting protocol combined with patient education in reducing postoperative opioid consumption after TURP.
• To compare pain control, patient satisfaction, and opioid utilization between a standard care group and a multimodal intervention group.

Main Methods:

• A prospective, randomized controlled trial involving 50 patients undergoing TURP.
• Patients were assigned to either standard of care (SOC) or a multimodal experimental group (MMG) receiving ibuprofen, enhanced pain management education, and no discharge opioid prescription.
• Data collected included demographics, operative details, pain scores, opioid use (morphine milligram equivalents), and patient satisfaction.

Main Results:

• The multimodal group demonstrated significantly lower post-discharge opioid use (0 MME vs. 4.1 MME, P=0.04).
• Inpatient opioid use was reduced in the MMG but did not reach statistical significance (6.0 vs. 9.8 MME, P=0.2).
• Pain control was non-inferior between groups (mean pain score 2.5 MMG vs. 2.4 SOC, P=0.0003), and patient satisfaction was similar (9.6 MMG vs. 9.2 SOC, P=0.32).

Conclusions:

• Implementing an opioid-limiting multimodal protocol and patient education effectively eliminates outpatient opioid use following TURP.
• This strategy maintains comparable pain control and patient satisfaction, while significantly reducing the risk of opioid-related adverse events.