Postoperative Opioid Prescribing After Female Pelvic Medicine and Reconstructive Surgery

Objective: This study aimed to provide female pelvic medicine and reconstructive surgery (FPMRS) providers with evidence-based guidance on opioid prescribing following surgery.

Methods: A literature search of English language publications between January 1, 2000, and March 31, 2021, was conducted. Search terms identified reports on opioid prescribing, perioperative opioid use, and postoperative pain after FPMRS procedures. Publications were screened, those meeting inclusion criteriawere reviewed, and datawere abstracted. Data regarding the primary objective included the oral morphine milligram equivalents of opioid prescribed and used after discharge. Information meeting criteria for the secondary objectives was collected, and qualitative data synthesis was performed to generate evidence-based practice guidelines for prescription of opioids after FPMRS procedures.

Results: A total of 6,028 unique abstracts were identified, 452 were screened, and 198 full-text articles were assessed for eligibility. Fifteen articles informed the primary outcome, and 32 informed secondary outcomes.

Conclusions: For opioid-naive patients undergoing pelvic reconstructive surgery, we strongly recommend surgeons to provide no more than 15 tablets of opioids (roughly 112.5 morphine milligram equivalents) on hospital discharge. In cases where patients use no or little opioids in the hospital, patients may be safely discharged without postoperative opioids. Second, patient and surgical factors that may have an impact on opioid use should be assessed before surgery. Third, enhanced recovery pathways should be used to improve perioperative care, optimize pain control, and minimize opioid use. Fourth, systemic issues that lead to opioid overprescribing should be addressed. Female pelvic medicine and reconstructive surgery surgeons must aim to balance adequate postoperative pain control with individual and societal risks associated with excess opioid prescribing.

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Work Title Postoperative Opioid Prescribing After Female Pelvic Medicine and Reconstructive Surgery
Access
Open Access
Creators
  1. Krista M.L. Reagan
  2. Sarah H. Boyles
  3. Taylor J. Brueseke
  4. Brian J. Linder
  5. Marcella G. Willis-Gray
  6. Sara B. Cichowski
  7. Jaime B. Long
Keyword
  1. Postoperative opioid
  2. Opioids
  3. Female pelvic medicine and reconstructive surgery
  4. Opioid prescribing
  5. Gynecologic surgery
  6. Postoperative pain control
  7. Perioperative care
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Female Pelvic Medicine & Reconstructive Surgery
Publication Date November 2021
Publisher Identifier (DOI)
  1. https://doi.org/10.1097/SPV.0000000000001113
Deposited March 18, 2024

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Version 1
published

  • Created
  • Added FPMRS_Postoperative_Opioid_Prescribing.pdf
  • Added Creator Krista M.L. Reagan
  • Added Creator Sarah H. Boyles
  • Added Creator Taylor J. Brueseke
  • Added Creator Brian J. Linder
  • Added Creator Marcella G. Willis-Gray
  • Added Creator Sara B. Cichowski
  • Added Creator Jaime Long
  • Published
  • Updated Keyword, Publisher, Description, and 1 more Show Changes
    Keyword
    • Postoperative opioid, Opioids, Female pelvic medicine and reconstructive surgery, Opioid prescribing, Gynecologic surgery, Postoperative pain control, Perioperative care
    Publisher
    • Journal of Pelvic Surgery
    • Female Pelvic Medicine & Reconstructive Surgery
    Description
    • Consensus statement
    • Objective: This study aimed to provide female pelvic medicine and reconstructive surgery (FPMRS) providers with evidence-based guidance on opioid prescribing following surgery.
    • Methods: A literature search of English language publications between January 1, 2000, and March 31, 2021, was conducted. Search terms identified reports on opioid prescribing, perioperative opioid use, and postoperative pain after FPMRS procedures. Publications were screened, those meeting inclusion criteriawere reviewed, and datawere abstracted. Data regarding the primary objective included the oral morphine milligram equivalents of opioid prescribed and used after discharge. Information meeting criteria for the secondary objectives was collected, and qualitative data synthesis was performed to generate evidence-based practice guidelines for prescription of opioids after FPMRS procedures.
    • Results: A total of 6,028 unique abstracts were identified, 452 were screened, and 198 full-text articles were assessed for eligibility. Fifteen articles informed the primary outcome, and 32 informed secondary outcomes.
    • Conclusions: For opioid-naive patients undergoing pelvic reconstructive surgery, we strongly recommend surgeons to provide no more than 15 tablets of opioids (roughly 112.5 morphine milligram equivalents) on hospital discharge. In cases where patients use no or little opioids in the hospital, patients may be safely discharged without postoperative opioids. Second, patient and surgical factors that may have an impact on opioid use should be assessed before surgery. Third, enhanced recovery pathways should be used to improve perioperative care, optimize pain control, and minimize opioid use. Fourth, systemic issues that lead to opioid overprescribing should be addressed. Female pelvic medicine and reconstructive surgery surgeons must aim to balance adequate postoperative pain control with individual and societal risks associated with excess opioid prescribing.
    Publication Date
    • 2021-11-01
    • 2021-11
  • Renamed Creator Jaime B. Long Show Changes
    • Jaime Long
    • Jaime B. Long
  • Updated