Opioid use following pelvic reconstructive surgery: a predictive calculator.

Area of Science:

• Urogynecology
• Pain Management
• Pharmacology

Background:

• Pelvic floor disorder surgeries often involve significant postoperative pain, leading to opioid prescriptions.
• Understanding actual opioid consumption versus prescription is crucial for optimizing pain management and reducing opioid misuse.

Purpose of the Study:

• To quantify opioid use in patients undergoing pelvic floor disorder surgery.
• To identify risk factors associated with opioid consumption exceeding the median.
• To develop a predictive tool for postoperative opioid use.

Main Methods:

• Prospective cohort study of 190 women aged 18-89 undergoing urogynecological surgery.
• Preoperative and 1- and 2-week postoperative questionnaires assessed pain and opioid use.
• Multivariate logistic regression identified risk factors for higher opioid consumption.

Main Results:

• Median prescribed opioids were 100 MME, while median used amounts were 15 MME (1 week) and 20 MME (2 weeks).
• Longer operative time (per hour) was associated with exceeding median opioid use at 1 week.
• Fibromyalgia diagnosis was significantly associated with exceeding median opioid use at 2 weeks.

Conclusions:

• Patients undergoing pelvic floor disorder surgery utilize substantially less opioid medication than prescribed.
• Operative time and fibromyalgia are key factors influencing postoperative opioid consumption.