Opioid Consumption After Urogynecologic Surgery: A Prospective Multicenter Observational Study Using a Text-Messaging...

Area of Science:

• Urogynecology
• Pain Management
• Pharmacology

Background:

• Postoperative opioid consumption is a critical factor in mitigating opioid misuse.
• Accurate quantification of outpatient opioid use after urogynecologic procedures is essential for developing effective pain management strategies.

Purpose of the Study:

• To quantify outpatient opioid consumption following urogynecologic surgery.
• To identify demographic and perioperative factors associated with high opioid consumption.

Main Methods:

• Prospective, multicenter cohort study involving women undergoing pelvic organ prolapse or urinary incontinence surgery.
• Daily opioid and nonopioid analgesic consumption, along with pain levels, were tracked via text messaging for two weeks postoperatively.
• Statistical analysis identified factors correlated with high opioid use (defined as >75th percentile of morphine milligram equivalents consumed).

Main Results:

• A total of 261 patients from 9 academic centers were analyzed.
• Median consumed morphine milligram equivalents (MME) were 28, while 75 MME were prescribed.
• Factors associated with high MME consumption included BMI > 30, chronic pain, elevated baseline pain, increased blood loss, longer operative time, and southern region location.

Conclusions:

• Urogynecology patients consumed significantly less opioids (median 28 MME) than prescribed (median 75 MME).
• Specific patient and surgical factors predict higher opioid requirements, enabling personalized prescribing.
• Findings can inform and enhance current opioid prescribing guidelines for urogynecologic surgery.