School of Medicine, University of Pittsburgh.
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center.
Female Pelvic Med Reconstr Surg. 2021 May 1;27(5):304-309. doi: 10.1097/SPV.0000000000000844.
The objective of this study was to determine total postoperative opioid consumption by women 60 years and older during the first week after pelvic organ prolapse surgery. We secondarily aimed to describe opioid prescribing patterns in this cohort.
This is a secondary analysis of a prospective cohort study assessing changes in cognition in women 60 years and older undergoing prolapse surgery. Postoperative opioid use at home during the first week was collected through daily self-reported diary entries. Total postoperative opioid consumption was calculated by adding opioid administration in the postoperative anesthesia recovery unit, inpatient setting, and home opioid use (as documented in diary). Regression models were used to identify demographic and clinical factors associated with total postoperative opioid consumption in the top quartile of this cohort and home opioid use.
Data from 80 women were analyzed. Mean ± SD age was 71.78 ± 6.14 years (range, 60-88 years). Fifty women (62.5%) underwent vaginal surgery, and 30 (7.5%) underwent laparoscopic/robotic surgery, with concomitant hysterectomy in 47 (58.8%). The median (interquartile range) total morphine milligram equivalents used during the first week after surgery was 30 (7.5-65.75). The median (interquartile range) total morphine milligram equivalents prescribed was 225 (150-225).
Opioid consumption after prolapse surgery in older women is very modest and equates to a median (interquartile range) of 4 (1-9) oxycodone (5 mg) tablets. Opioid prescribing patterns should be adjusted accordingly.
本研究旨在确定 60 岁及以上女性骨盆器官脱垂手术后第一周的总术后阿片类药物消耗量。我们的次要目的是描述该队列中阿片类药物的开具模式。
这是一项前瞻性队列研究的二次分析，该研究评估了 60 岁以上接受脱垂手术的女性认知能力的变化。通过每日自我报告的日记条目记录，收集术后第一周在家中使用的阿片类药物。通过将术后麻醉恢复单元、住院期间和家庭中使用的阿片类药物（如日记中记录的）相加，计算总术后阿片类药物消耗量。使用回归模型确定与该队列中总术后阿片类药物消耗量（最高四分位数）和家庭中阿片类药物使用相关的人口统计学和临床因素。
对 80 名女性的数据进行了分析。平均年龄±标准差为 71.78±6.14 岁（范围 60-88 岁）。50 名女性（62.5%）接受了阴道手术，30 名女性（7.5%）接受了腹腔镜/机器人手术，47 名女性（58.8%）同时接受了子宫切除术。术后第一周使用的总吗啡毫克当量中位数（四分位距）为 30（7.5-65.75）。开的总吗啡毫克当量中位数（四分位距）为 225（150-225）。
老年女性脱垂手术后阿片类药物的消耗量非常低，相当于中位数（四分位距）4（1-9）片羟考酮（5 毫克）。阿片类药物的开具模式应相应调整。
