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Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis
Sarah Diaz1, Kara K Brockhaus2, Matthew C Bobel1
1Department of Surgery, St Joseph Mercy Hospital Ann Arbor, Ann Arbor, MI, USA.
Background:
Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive.
Methods:
Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge.
Results:
641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly higher NPS for the Benign than the Malignant group preoperative and postoperative day 0 (after surgery), 1, 2, and 3 (all p ≤ 0.001). Opioids prescribed at discharge were significantly higher in the Benign group (60.0% vs 51.1%, p = 0.018). After regression analysis, there was no longer a significant difference in NPS (B = 0.703, p = 0.095) and opioids prescribed between groups [OR = 0.803 (95%CI 0.586, 1.1), p = 0.173].
Conclusions:
Pain and opioids prescribed at discharge are not significantly different between benign and malignant diseases in an enhanced recovery pain management pathway that maximizes non-opioid multimodal analgesic strategies.
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