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Updated: Sep 20, 2025

Murine Ileocolic Bowel Resection with Primary Anastomosis
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Long-Term Opioid Use After Colon and Rectal Surgery.

Kerri A McKie1, Robert A Malizia1, Adam C Fields1

  • 1Division of Colorectal Surgery, Brigham and Women's Hospital, Boston, Massachusetts.

The Journal of Surgical Research
|May 23, 2025
PubMed
Summary
This summary is machine-generated.

Standardized nonnarcotic Enhanced Recovery After Surgery (ERAS) pathways reduced long-term opioid use in opioid-naïve patients undergoing colorectal surgery. This study shows a stepwise decrease in persistent opioid use from 2017 to 2020.

Keywords:
CollaborativeColorectalERASOpioid reductionSurgery

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Area of Science:

  • Colorectal Surgery
  • Pain Management
  • Public Health

Background:

  • The United States faces a significant opioid epidemic.
  • Enhanced Recovery After Surgery (ERAS) pathways aim to minimize perioperative opioid consumption.
  • Opioid-naïve patients undergoing colorectal surgery are the focus for evaluating long-term opioid use.

Purpose of the Study:

  • To determine if standardized, nonnarcotic ERAS protocols decrease long-term opioid use in opioid-naïve patients after colorectal surgery.
  • To analyze trends in persistent opioid use postoperatively.

Main Methods:

  • Retrospective cohort study of 1363 opioid-naïve patients from 2017-2020.
  • Data sourced from the American College of Surgeons National Surgical Quality Improvement Program and Epic Systems.
  • Standardized ERAS protocols were implemented across five institutions.

Main Results:

  • A stepwise reduction in long-term opioid use was observed from 2017 to 2020.
  • Persistent opioid use at 6 and 12 months decreased significantly over the study period (P < 0.01).
  • For instance, 16% and 11% of patients used opioids at 6 and 12 months in 2017-2018, versus 11% and 4% in 2019-2020.

Conclusions:

  • Standardizing opioid-sparing strategies within ERAS pathways effectively reduced long-term opioid use.
  • A small percentage of opioid-naïve patients may still experience persistent opioid use one year post-surgery.
  • The findings support the use of nonnarcotic ERAS protocols to combat the opioid crisis in surgical settings.