Director of Minimally Invasive Surgery, From the Department of Obstetrics and Gynecology, Baylor College of Medicine, 6651 Main Street, Suite F1020, Houston, TX, 77030, USA.
J Robot Surg. 2022 Apr;16(2):421-427. doi: 10.1007/s11701-021-01259-8. Epub 2021 Jun 2.
We aimed to identify the amount of opioids used in the postoperative setting for patients with a history of chronic pelvic pain undergoing robotic surgical excision of endometriosis and compare this to patients undergoing benign robotic gynecologic surgery for other indications. We conducted a retrospective cohort study in an urban academic university hospital from January 2019 to March 2020. Data regarding opioid use was collected via a patient-reported survey that was given at the 3 weeks follow-up visit. Data regarding opioid use was compared to patients undergoing robotic surgery for other benign gynecologic indications. Our study included 158 patients, 119 undergoing surgery for endometriosis and 39 patients undergoing robotic surgery for other benign gynecologic indications. Patients undergoing surgery for endometriosis used on average 105.9 morphine milligram equivalents (MME), equivalent to 14 tabs of oxycodone 5 mg. There was no statistically significant difference in the amount of opioids used postoperatively based on stage of endometriosis or need for hysterectomy. Patients undergoing surgery for other benign indications used on average 49.4 MME, equivalent to 6 tabs of oxycodone 5 mg. The difference in amount of opioids used between patients with and without endometriosis was statistically significant. In conclusion, patients undergoing robotic surgery for endometriosis used over two times as many opioids postoperatively as patients without endometriosis and have a higher perceived postoperative pain. Providers should be aware of this difference in order to provide better pain control for this patient population.
我们旨在确定有慢性盆腔痛病史的患者在接受机器人手术切除子宫内膜异位症的术后使用阿片类药物的量，并将其与因其他适应证接受机器人良性妇科手术的患者进行比较。我们在 2019 年 1 月至 2020 年 3 月期间在一家城市学术大学医院进行了一项回顾性队列研究。通过在 3 周随访时给予患者的患者报告调查收集了关于阿片类药物使用的数据。将阿片类药物使用数据与因其他良性妇科适应证接受机器人手术的患者进行比较。我们的研究包括 158 名患者，119 名因子宫内膜异位症接受手术，39 名因其他良性妇科适应证接受机器人手术。因子宫内膜异位症接受手术的患者平均使用 105.9 吗啡毫克当量（MME），相当于 14 片 5mg 羟考酮。根据子宫内膜异位症的分期或是否需要子宫切除术，术后使用的阿片类药物量没有统计学上的显著差异。因其他良性适应证接受手术的患者平均使用 49.4 MME，相当于 6 片 5mg 羟考酮。有和没有子宫内膜异位症的患者之间使用的阿片类药物量的差异具有统计学意义。总之，因子宫内膜异位症接受机器人手术的患者术后使用的阿片类药物量是没有子宫内膜异位症的患者的两倍多，并且术后疼痛感知更高。提供者应该意识到这种差异，以便为这一患者群体提供更好的疼痛控制。
