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Ambulatory Robotic Colectomy: Factors Affecting and Affected by Postoperative Opioid Use
Michael M Vu1, Jace J Franko1, Anna Buzadzhi2
1Madigan Army Medical Center.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|February 16, 2024
Summary
Ambulatory robotic colectomies show low opioid use and readmission rates. However, insufficient recovery pain control may increase readmissions and outpatient opioid needs.
Area of Science:
- Colorectal Surgery
- Robotic Surgery
- Pain Management
Background:
- The opioid crisis necessitates understanding postoperative opioid use.
- Ambulatory robotic colectomies offer early discharge but raise pain control concerns.
Purpose of the Study:
- Identify factors influencing recovery room opioid use (ROU) and additional outpatient opioid prescriptions (AOP).
- Evaluate outcomes after ambulatory robotic colectomies.
Main Methods:
- Retrospective review of 219 ambulatory robotic colon resections (2019-2022).
- Included patients discharged same day (SDD) or postoperative day 1 (POD1).
- Assessed ROU (MMEs), AOP, ED visits, and readmissions.
Main Results:
- Mean ROU was 29.4 MMEs; 8.7% required AOP.
- No significant differences in outcomes between SDD and POD1 groups.
- Older age, higher BMI, and right-sided colectomies associated with lower ROU.
- Lower ROU linked to increased readmissions and, for SDD patients, higher AOP.
Conclusions:
- Ambulatory robotic colectomies and SDD are feasible with low opioid use and readmission rates.
- Adequate postoperative pain management is key to reducing readmissions and AOP.
- Low ROU may indicate inadequate pain control, potentially leading to adverse outcomes.
