Minimally invasive sigmoidectomy for diverticular disease decreases inpatient opioid use: Results of a propensity score-matched study.
Publication Title
American journal of surgery
Document Type
Article
Publication Date
8-1-2020
Keywords
Adolescent; Adult; Aged; Analgesics, Opioid; Digestive System Surgical Procedures; Diverticular Diseases; Drug Utilization; Female; Hospitalization; Humans; Laparoscopy; Male; Middle Aged; Minimally Invasive Surgical Procedures; Propensity Score; Retrospective Studies; Robotic Surgical Procedures; Young Adult
Abstract
BACKGROUND: Patients undergoing gastrointestinal surgery are at high risk for postoperative opioid use.
METHODS: We evaluated inpatient opioid use among patients undergoing sigmoidectomy for diverticular disease from the Premier Hospital Database and compared across surgical approaches using propensity score-matching analysis.
RESULTS: After the day of surgery, minimally invasive (MIS) patients were administered significantly lower doses of parenteral opioids (median daily morphine milligram equivalents [MME]: 33.3 versus 48.3, p < 0.001). Within MIS, significantly less parenteral opioids were used by the robotic-assisted (RS) than the laparoscopic (LS) group (median daily MME: 30.0 versus 36.8, p = 0.012). MIS patients were more likely than open to start oral opioids on the day of surgery (MIS vs. OS: 8.7% vs. 6.6%, p < 0.001; RS vs. LS: 12.6% vs. 10.2%, p = 0.048).
CONCLUSION: Minimally invasive sigmoidectomy for diverticular disease was associated with less postoperative parenteral opioid use and starting oral opioids sooner after surgery compared to the open approach.
Area of Special Interest
Digestive Health
Specialty/Research Institute
Surgery
Specialty/Research Institute
Swedish Digestive Health Institute
Specialty/Research Institute
Gastroenterology
