Predictors of new persistent opioid use after benign hysterectomy in the United States

AlAshqar, Abdelrahman; ISHIWATA, Ryota; Moss, Chailee; Andersen, Kathleen M.; Yanek, Lisa R.; Bicket, Mark C.; Alexander, G. Caleb; Borahay, Mostafa A.

doi:10.1016/j.ajog.2022.02.030

Cited by 6 publications

(1 citation statement)

References 31 publications

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“…While preoperative activity level was not significantly associated with postoperative pain nor opioid use, younger age was associated with higher postoperative pain scores, which echoes findings from previous studies. In patients undergoing gynecologic surgery for benign indications, younger age has been associated with increased perioperative opioid use as well as persistent opioid use after surgery 23,24 . In the urogynecologic surgery literature, Willis-Gray et al 11 noted that age younger than 65 years was associated with higher maximum pain scores in the postanesthesia care unit and resultant postanesthesia care unit opioid utilization 11 .…”

Section: Discussionmentioning

confidence: 99%

Preoperative Activity Level and Postoperative Pain After Pelvic Reconstructive Surgery

Sakai¹,

Willis-Gray

2023

UROGC

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Importance Higher preoperative activity level is associated with improved postoperative outcomes, but its impact on postoperative pain after urogynecologic surgery is unknown. Objective The aim of the study was to assess the relationship between preoperative activity level and postoperative pain. Study Design In this prospective cohort study, we evaluated women undergoing pelvic reconstructive surgery from April 2019 through September 2021. We used the Activity Assessment Survey (AAS) to create cohorts of high (AAS = 100) and low (AAS < 100) baseline activity (BA). Our primary outcome was postoperative pain scores. Our secondary outcome was postoperative opioid use. Results Of 132 patients, 90 (68%) were in the low BA group and 42 (32%) were in the high BA group. The groups were similar in age (mean 59 ± 12 years for high BA vs 60 ± 12 for low BA, P = 0.70), body mass index, and surgical procedures performed; however, the high BA group had lower preoperative pain scores (2 ± 6 vs 11 ± 9, P ≤ 0.01). For the primary outcome, the high BA group reported lower postoperative pain scores (16 ± 8 vs 20 ± 9, P = 0.02) and less opioid use (19 ± 32 vs 52 ± 70 morphine milliequivalents, P = 0.01) than the low BA group. However, when adjusting for age, baseline pain, hysterectomy, baseline opioid use, and Charlson Comorbidity Index, high BA did not remain associated with lower postoperative pain scores and less opioid use. Conclusion A higher preoperative activity level among patients undergoing urogynecologic surgery was not associated with lower pain scores nor decreased opioid use.

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Section: Discussionmentioning

confidence: 99%