Sex Differences in Opioid-Sparing Regimen Prescribing Following Ventral Hernia Repair

Area of Science:

• Surgery
• Pain Management
• Sex Differences in Medicine

Background:

• Sex differences significantly impact pain therapy response, yet data on sex-specific postoperative pain management remain equivocal.
• Understanding these differences is crucial for optimizing patient care following surgical procedures.

Purpose of the Study:

• To investigate if patient sex predicts differences in postoperative pain management strategies.
• Specifically examining pain management in patients undergoing ventral hernia repair (VHR).

Main Methods:

• Retrospective analysis of prospectively collected VHR data from the Abdominal Core Health Quality Collaborative.
• Inclusion of opioid-naïve adult patients undergoing nonemergent, uncomplicated VHR.
• Multinomial logistic regression to assess differences in postoperative opioid regimens based on patient sex.

Main Results:

• The study included 1325 males and 827 females undergoing VHR.
• Adjusted analysis revealed female patients were less likely than male patients to receive an opioid-sparing pain regimen (OR=0.647, P=0.012).
• Females exhibited a higher analgesic response and lower postoperative morphine consumption compared to males.

Conclusions:

• Female VHR patients received opioid-sparing regimens less frequently than males, despite better pain response.
• There is a critical need to educate clinicians on sex-specific pain and analgesia differences.
• Improved clinician awareness can lead to more equitable and effective postoperative pain management.