Persistent opioid use among gynecologic oncology patients after surgery

This study aimed to identify rates of persistent opioid use at 30 and 90 days postoperatively among patients undergoing surgery for a known or suspected gynecologic malignancy, and to identify patient characteristics that predict persistent opioid use.

A questionnaire was administered to patients 30 days postoperatively to assess patterns of opioid use; responses were validated by chart review. Propensity score matching was used to compare patients with and without opioid use at 30 days to identify whether a history of anxiety, depression, chronic pain, substance use, or any 30-day postoperative complications conferred a higher risk of persistent opioid use.

Of 752 patients who received the questionnaire, 596 (79.3 %) responded. Of the 431 opioid-naïve patients included in the analysis, 12 (2.8 %) were using opioids at 30 days and 2 (0.5 %) were using opioids at 90 days postoperatively. Patients with persistent opioid use at 30 days had no difference in history of anxiety, depression, chronic pain, or substance use than patients without persistent opioid use. Patients with postoperative complications were more likely to be using opioids at 30 days (33.3 %) than those without complications (8.3 %, p = .055).

The rate of persistent postoperative opioid use in gynecologic oncology patients is low when compared to previously identified rates among similar populations. No association was found between anxiety, depression, chronic pain, or history of substance use and persistent opioid use at 30 days postoperatively. This study may help providers identify optimal prescribing strategies in gynecologic oncology.