Perioperative Narcotic Trends in Women Undergoing Minimally Invasive Myomectomy.
J Minim Invasive Gynecol
; 27(6): 1383-1388.e1, 2020.
Article
en En
| MEDLINE
| ID: mdl-31600573
ABSTRACT
STUDY OBJECTIVE:
Evaluate the perioperative narcotic utilization patterns at the time of myomectomy, specifically as they relate to the opioid epidemic. We also aim to evaluate the differences between conventional laparoscopy and robotic surgery in terms of narcotic utilization.DESIGN:
Retrospective cohort study.SETTING:
Single academic university hospital. PATIENTS Women undergoing minimally invasive myomectomy.INTERVENTIONS:
Laparoscopic or robot-assisted myomectomy. MEASUREMENTS AND MAINRESULTS:
We identified 312 minimally invasive myomectomies to be included in the final analysis. For the entire cohort, the mean age (± standard deviation) was 35.7 ± 5.1 years, and the mean body mass index was 28.3 ± 6.3. Of the 312 myomectomies included, 239 (76.6%) were performed using robotic assistance, and the remainder (23.4%) were performed by conventional laparoscopy. A statistically significant inverse relationship was found between year of myomectomy and perioperative narcotic administration (p <.001). Yearly morphine milligram equivalent (MME) administration decreased significantly for both intraoperative and postoperative administration (p <.001). The largest decline for intraoperative MME use was between 2016 and 2017, and for postoperative MME use, it was between 2012 and 2013. There was no statistically significant difference in perioperative narcotic administration between conventional laparoscopy and robot-assisted myomectomy. The time effect for intraoperative (p <.001) and postoperative (p <.001) narcotic administration remained significant after adjusting for covariates, including mode of surgery, race, insurance, age, and body mass index. None of the background variables assessed were associated with perioperative narcotic administration.CONCLUSION:
Perioperative narcotic administration for minimally invasive myomectomy has decreased following widespread awareness of the national opioid crisis.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Dolor Postoperatorio
/
Procedimientos Quirúrgicos Mínimamente Invasivos
/
Manejo del Dolor
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Miomectomía Uterina
/
Narcóticos
Tipo de estudio:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
J Minim Invasive Gynecol
Asunto de la revista:
GINECOLOGIA
Año:
2020
Tipo del documento:
Article