Amir L Bastawrous1, I-Fan Shih2, Yanli Li2, Robert K Cleary3. 1. Swedish Medical Center, Seattle, WA, USA. 2. Intuitive Surgical, Inc, Sunnyvale, CA, USA. 3. Saint Joseph Mercy Health System, Ann Arbor, MI, USA. Electronic address: Robert.Cleary@stjoeshealth.org.
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.
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.
Authors: Yuki Hirata; Russell G Witt; Laura R Prakash; Elsa M Arvide; Kristen A Robinson; Vijaya Gottumukkala; Ching-Wei D Tzeng; Paul Mansfield; Brian D Badgwell; Naruhiko Ikoma Journal: Ann Surg Oncol Date: 2022-05-04 Impact factor: 4.339
Authors: Sarah E Diaz; Yongjin F Lee; Amir L Bastawrous; I-Fan Shih; Shih-Hao Lee; Yanli Li; Robert K Cleary Journal: Surg Endosc Date: 2022-02-22 Impact factor: 3.453
Authors: Amir L Bastawrous; Kara K Brockhaus; Melissa I Chang; Gediwon Milky; I-Fan Shih; Yanli Li; Robert K Cleary Journal: Surg Endosc Date: 2021-02-10 Impact factor: 4.584