Journal article
Effect of Enhanced Recovery Protocol on Opioid Use in Pelvic Organ Prolapse Surgery
Female pelvic medicine & reconstructive surgery, Vol.27(12), pp.E705-E709
12/01/2021
DOI: 10.1097/SPV.0000000000001114
PMCID: PMC8900056
PMID: 34807884
Abstract
Objectives Our primary objective was to compare the total opioid use by patients undergoing apical pelvic organ prolapse surgery before and after implementation of an enhanced recovery protocol (ERP). Methods Participants of this ambispective cohort study included a "pre-ERP" retrospective cohort and an "ERP" cohort of patients prospectively enrolled after the full implementation of the ERP in January 2019. Demographic and clinical data were collected from the electronic record. Descriptive statistics were used for demographic variables. Total opioid use was calculated for each participant using morphine milligram equivalents (MMEs) and compared between cohorts using the Student t test. Results Study participants (n = 65) were similar between cohorts and had a mean (SD) age of 62.4 (9.7) years and body mass index of 28.9 (4.8), and had a median parity of 3 (interquartile range, 2-4). Comorbid conditions, assessed with the Charlson Comorbidity Index, were also similar, with a mean (SD) of 2 (2.9). Hysterectomy approach and apical procedures did not differ between groups. After ERP implementation, mean (SD) intraoperative and postoperative MMEs decreased significantly (59.4 [31.6] vs 36.9 [20.5], P < 0.01). Total MMEs prescribed at discharge also decreased (392.3 [88.4] vs 94.6 [61.3], P < 0.01). Total anesthesia time and surgical time were similar, whereas mean total admission time decreased (27.3 [10.8] vs 18 [8.6] hours, P < 0.01). Telephone calls within 30 days increased from mean 1 (1.0) to 2.2 (1.9) (P < 0.01), whereas clinic visits and 30-day readmissions did not differ. Conclusions Women undergoing apical pelvic organ prolapse surgery at an academic medical center received significantly fewer opioids after implementation of an ERP without a change in postoperative pain scores.
Details
- Title: Subtitle
- Effect of Enhanced Recovery Protocol on Opioid Use in Pelvic Organ Prolapse Surgery
- Creators
- Allen A. Mehr - University of Iowa Hospitals and ClinicsCaroline Elmer-Lyon - Univ Iowa Hosp & Clin, Dept Obstet & Gynecol, Iowa City, IA 52242 USAErin Maetzold - Univ Iowa Hosp & Clin, Dept Obstet & Gynecol, Iowa City, IA 52242 USACatherine S. Bradley - University of IowaJoseph T. Kowalski - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Female pelvic medicine & reconstructive surgery, Vol.27(12), pp.E705-E709
- DOI
- 10.1097/SPV.0000000000001114
- PMID
- 34807884
- PMCID
- PMC8900056
- NLM abbreviation
- Female Pelvic Med Reconstr Surg
- ISSN
- 2151-8378
- eISSN
- 2154-4212
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 5
- Grant note
- UL1TR002537 / National Center for Advancing Translational Sciences of the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS)
- Language
- English
- Date published
- 12/01/2021
- Academic Unit
- Epidemiology; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984318321402771
Metrics
16 Record Views