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Decreased Opioid Prescription With Low Pain Scores After Urethroplasty: Using a Simplified, Multimodal, Opioid

Imani Butler1, Pegah Taheri2, Prachi Khanna1

  • 1Dell Medical School, The University of Texas at Austin, Austin, TX.

Urology
|February 17, 2024
PubMed
Abstract

Insights

A new opioid-minimized pain management protocol for urethroplasty significantly reduced opioid prescriptions without impacting pain control or quality of life. This simplified approach effectively lowers opioid use post-surgery.

Area of Science:

  • Urology
  • Pain Management
  • Surgical Outcomes

Background:

  • Urethroplasty often involves significant postoperative pain, historically managed with opioids.
  • Minimizing opioid use is crucial to reduce risks of dependence and side effects.
  • Multimodal pain management (MPM) offers a strategy to address pain while limiting opioid reliance.

Purpose of the Study:

  • To implement and evaluate a simplified, opioid-minimized, multimodal pain management (MPM) protocol for patients undergoing urethroplasty.
  • To assess the protocol's effectiveness in reducing opioid consumption.
  • To determine if the protocol maintains low postoperative complications, pain scores, and quality of life interference.

Main Methods:

  • Retrospective review of a standard pain management (SPM) cohort and prospective study of an MPM cohort for urethroplasty patients.
  • Comparison of postoperative pain scores and opioid dispensing records between the SPM and MPM groups.
  • Utilized Electronic Medical Records and Prescription Monitoring Programs for data collection.

Main Results:

  • The MPM cohort received 75 fewer morphine milligram equivalents of opioids compared to the SPM cohort (P < .001).
  • Opioid discharge prescriptions decreased from 50% in SPM to 11% in MPM (P < .001).
  • Postoperative pain, quality of life interference, and complication rates remained low and comparable between groups.

Conclusions:

  • A simplified MPM protocol effectively reduces postoperative opioid use after urethroplasty.
  • This approach maintains low pain levels and does not negatively impact quality of life or increase complications.
  • The MPM protocol is easily adoptable for decreasing opioid prescriptions in urethroplasty patients.

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