Abstract
Discussion Forum (0)
Introduction: Decreasing opioid use during postoperative period is a topic of great ongoing interest. We aimed to determine whether regional anesthesia with single-shot intrathecal opioid injections (ITO) reduced intravenous (IV) opioid use after exploratory laparotomy in gynecologic oncology surgeries.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
Introduction: Decreasing opioid use during postoperative period is a topic of great ongoing interest. We aimed to determine whether regional anesthesia with single-shot intrathecal opioid injections (ITO) reduced intravenous (IV) opioid use after exploratory laparotomy in gynecologic oncology surgeries.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
Preoperative intrathecal opioid injection on postoperative analgesia requirements in gynecologic oncology
Dr. Eileen Hou
Abstract
Discussion Forum (0)
Introduction: Decreasing opioid use during postoperative period is a topic of great ongoing interest. We aimed to determine whether regional anesthesia with single-shot intrathecal opioid injections (ITO) reduced intravenous (IV) opioid use after exploratory laparotomy in gynecologic oncology surgeries.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
Introduction: Decreasing opioid use during postoperative period is a topic of great ongoing interest. We aimed to determine whether regional anesthesia with single-shot intrathecal opioid injections (ITO) reduced intravenous (IV) opioid use after exploratory laparotomy in gynecologic oncology surgeries.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
Methods: A retrospective chart review with institution IRB approval of 314 consecutive gynecologic oncology patients undergoing exploratory laparotomy from July 2015 to January 2018 was conducted. Single-shot ITO was offered to all patients undergoing open abdominal surgery. The primary outcomes of interest were self-reported post-operative pain levels and IV opioid use in morphine equivalents during the first 48 hours after surgery. Univariate analyses were performed to estimate the effect of ITO on IV opioid use at 0, 6, 12, 24 and 48 hours after surgery. The relationship between ITO and primary outcomes of interest were determined using longitudinal regression analysis and adjusted for confounding variables.
Results: 34% (107/314) received ITO preoperatively. There were no differences in patient age, BMI, number of prior abdominal surgeries, history of opioid dependence, or EBL between the ITO and control groups. Preoperative ITO was associated with significantly lower IV opioid requirement between 0-6 hours after surgery (9.7±8.1 vs 14.3±11.5, p < 0.0001) and between 6-12 hours after surgery (2.7±3.8 vs 5.4±9.5, p=0.0054). In addition to reduced IV opioid use in ITO group, no differences in self-reported postoperative pain levels were noted in the first 48 hours post-operatively.
Conclusion/Implications: Preoperative ITO reduced postoperative opioid requirement for pain control without negatively affecting patients' self-reported pain level.
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