A Systematic Review of Perioperative Opioid Management for Minimally Invasive Hysterectomy

Johnson, Claire M.; Makai, G.

doi:10.1016/j.jmig.2018.08.024

Cited by 22 publications

(15 citation statements)

References 52 publications

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“…Opioid use and opioid‐related adverse effects are associated with higher hospital costs and longer stays in hospital 22 . In a recently published review, 23 persistent use of opioids was identified in 1.5% of women undergoing hysterectomy. The average use of oxycodone in the first 24 hours postoperatively was 20 mg.…”

Section: Discussionmentioning

confidence: 99%

Recovery after enhanced versus conventional care laparoscopic hysterectomy performed in the afternoon: A randomized controlled trial

Kilpio

Härkki

Mentula

et al. 2020

Intl J Gynecology & Obste

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Objective: To compare enhanced recovery after surgery (ERAS) and conventional care (CC) protocols on outcomes of laparoscopic hysterectomy (LH) performed in the afternoon. Methods: A single-center randomized controlled trial was conducted on 120 women undergoing LH who were randomly divided into the intervention group (IG; n=60) and control group (CG; n=60). Women in the IG were treated according to the ERAS protocol and those in the CG according to the CC protocol. The primary outcome was the length of hospitalization. Secondary outcomes were postoperative opioid use, postoperative pain and emesis, complications, operative bleeding, and time. Results: More women discharged during 24 hours in the IG than in the CG (88% vs 55%, P<0.001). The time to actual discharge (19 vs 22 hours, P<0.001) and ready-todischarge time (15 vs 21 hours, P<0.001) were shorter and the use of oxycodone was lower (0 mg [0-0 vs 2.5 mg [0-10], P<0.001) in the IG than in the CG, respectively. Otherwise, no other significant differences between the groups were observed. The follow-up time was one month. Conclusion: The ERAS protocol reduces hospital stay and decreases the use of opioids with no impairment in surgical outcome of LH.

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Section: Discussionmentioning

confidence: 99%

Recovery after enhanced versus conventional care laparoscopic hysterectomy performed in the afternoon: A randomized controlled trial

Kilpio

Härkki

Mentula

et al. 2020

Intl J Gynecology & Obste

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“…After MIH, most women only use half of the opioids prescribed [113]. A recent systematic review of perioperative opioid use in this instance recommends that prescribers closely evaluate each patient and strive for needs-based opioid prescribing, highlighting that most patients use fewer than 10 oxycodone 5-mg equivalents at the time of hysterectomy [114]. The Michigan Surgical Quality Collaborative and Opioid Prescribing Engagement Network has gone on to publish opioid-prescribing recommendations for MIH, and recommends dispensing no more than 15 tablets for all types of hysterectomy: vaginal, abdominal, and laparoscopic/robotic approaches [115].…”

Section: Postoperative Opioid Prescribing For Narcotic-naive Patientsmentioning

confidence: 99%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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This is the first Enhanced Recovery After Surgery (ERAS) guideline dedicated to standardizing and optimizing perioperative care for women undergoing minimally invasive gynecologic surgery. The guideline was rigorously formulated by an American Association of Gynecologic Laparoscopists Task Force of US and Canadian gynecologic surgeons with special interest and experience in adapting ERAS practices for patients requiring minimally invasive gynecologic surgery. It builds on the 2016 ERAS Society recommendations for perioperative care in gynecologic/oncologic surgery by serving as a more comprehensive reference for minimally invasive endoscopic and vaginal surgery for both benign and malignant gynecologic conditions. For example, the section on preoperative optimization provides more specific recommendations derived from the ambulatory surgery and anesthesia literature for the management of anemia, hyperglycemia, and obstructive sleep apnea. Recommendations pertaining to multimodal analgesia account for the recent Food and Drug Administration warnings about respiratory depression from gabapentinoids. The guideline focuses on workflows important to high-value care in minimally invasive surgery, such as same-day discharge, and tackles controversial issues in minimally invasive surgery, such as thromboprophylaxis. In these ways, the guideline supports the American Association of Gynecologic Laparoscopists and our collective mission to elevate the quality and safety of healthcare for women through excellence in clinical practice.

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“…Gynecologic procedures account for 7.7% of all surgeries performed in women representing an important generator of opioid prescriptions 10 . Hysterectomy is the most common gynecologic surgery performed and the current literature largely explores opioid use exclusively for hysterectomy 5,9,[11][12][13] . Much less is known about opioid prescribing trends and rates of persistent use following non-hysterectomy gynecologic surgeries.…”

Section: Introductionmentioning

confidence: 99%

Opioid Prescribing Practices for Women Undergoing Elective Gynecologic Surgery

Chan

Lam

et al. 2021

Journal of Minimally Invasive Gynecology

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A Systematic Review of Perioperative Opioid Management for Minimally Invasive Hysterectomy

Cited by 22 publications

References 52 publications

Recovery after enhanced versus conventional care laparoscopic hysterectomy performed in the afternoon: A randomized controlled trial

Recovery after enhanced versus conventional care laparoscopic hysterectomy performed in the afternoon: A randomized controlled trial

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Opioid Prescribing Practices for Women Undergoing Elective Gynecologic Surgery

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