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Impact of methocarbamol on opioid use after ventral incisional hernia repair

Shivani Desai1, Cecilia Carbonell2, Katherine Hoffman1

  • 1Prisma Health Department of Surgery, USA.

American Journal of Surgery
|July 22, 2023
PubMed
Abstract

Insights

Methocarbamol use after ventral hernia repair (VHR) significantly reduced opioid dosage prescribed at discharge. This muscle relaxant did not increase the need for opioid refills, offering a safer pain management alternative.

Area of Science:

  • Pain Management
  • Surgical Outcomes
  • Pharmacology

Background:

  • Opioid analgesia carries risks of abuse and diversion, necessitating alternatives.
  • Musculoskeletal pain is a major factor in postoperative pain following ventral hernia repair (VHR).
  • This study investigates methocarbamol's effect on opioid prescribing patterns after VHR.

Purpose of the Study:

  • To evaluate the impact of methocarbamol on opioid prescribing practices post-ventral hernia repair (VHR).
  • To determine if methocarbamol influences opioid refill rates in VHR patients.
  • To assess methocarbamol as a component of multimodal analgesia for VHR.

Main Methods:

  • Retrospective review of robotic and open VHR cases from January 2020 to July 2022.
  • Data collected via the Abdominal Core Health Quality Collaborative (ACHQC) and supplementary chart review for opioid refills.
  • A 2:1 propensity score match compared opioid prescribing in patients who received methocarbamol versus those who did not.

Main Results:

  • 101 patients received methocarbamol compared to 202 controls.
  • Opioid prescription rates were similar (87.1% vs 86.6%, p=0.904).
  • Patients on methocarbamol received significantly lower morphine milligram equivalent (MME) doses at discharge (60 vs 75, p=0.021) with no difference in refill rates (12.5% vs 16.6%, p=0.386).

Conclusions:

  • Methocarbamol addition to multimodal analgesia after VHR reduces prescribed opioid dosage.
  • Incorporating methocarbamol does not lead to an increased need for opioid refills.
  • Methocarbamol represents a viable strategy to decrease opioid utilization in VHR postoperative pain management.
Keywords:
MethocarbamolMultimodal analgesiaOpioidVentral incisional hernia repair

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