Nwosu Ikunna, Bougie Olga, Pudwell Jessica
Department of Obstetrics and Gynecology, Queen's, University, Kingston Health Sciences Centre, Kingston, ON; Queen's University School of Medicine, Kingston, ON.
Department of Obstetrics and Gynecology, Queen's, University, Kingston Health Sciences Centre, Kingston, ON.
J Obstet Gynaecol Can. 2022 Mar;44(3):240-246.e1. doi: 10.1016/j.jogc.2021.09.019. Epub 2021 Oct 14.
To evaluate surgeon opioid prescribing patterns for patients undergoing hysterectomy for benign indication, as well as patient use of postoperative medications and satisfaction with postoperative pain management.
Patients undergoing hysterectomy for benign indications at Kingston Health Sciences Centre were invited to participate in a telephone survey 2 weeks post-surgery to review their analgesia use and pain management. Patient demographics, medical history, intraoperative surgical details, and postoperative prescriptions were gathered through patient record review. Opioid prescribing and utilization patterns were assessed, as was satisfaction with postoperative pain management.
Of 124 eligible patients 110 (89%) completed the telephone survey, a mean 15.9 ± 2.3 days after surgery. The mean age of participants was 51.6 ± 11.9 years. Most surgeries (84.5%) were minimally invasive, and 45.5% of patients were discharged within 24 hours of surgery. An opioid prescription was given to 71.8% of participants, and 52.7% used at least 1 dose of opioid medication after discharge. Most participants described very good or adequate postoperative pain management (88.2%). Satisfaction with postoperative pain control was not associated with receipt of an opioid prescription (P = 0.89). A greater proportion of those who used 1 or more doses of opioids versus none indicated poor or inadequate pain management (19.0% vs. 4.1%; P = 0.035).
Many patients do not use postoperative opioid analgesia following hospital discharge after hysterectomy, without experiencing poor pain management. Surgeons should assess each individual and tailor the analgesia plan as necessary, optimizing non-opioid options.
评估因良性指征接受子宫切除术患者的外科医生阿片类药物处方模式，以及患者术后药物使用情况和对术后疼痛管理的满意度。
邀请在金斯顿健康科学中心因良性指征接受子宫切除术的患者在术后2周参加电话调查，以回顾其镇痛药物使用情况和疼痛管理情况。通过查阅患者记录收集患者人口统计学信息、病史、术中手术细节和术后处方。评估阿片类药物的处方和使用模式，以及对术后疼痛管理的满意度。
124名符合条件的患者中，110名（89%）完成了电话调查，平均在术后15.9±2.3天。参与者的平均年龄为51.6±11.9岁。大多数手术（84.5%）为微创手术，45.5%的患者在术后24小时内出院。71.8%的参与者获得了阿片类药物处方，52.7%的患者在出院后至少使用了1剂阿片类药物。大多数参与者表示术后疼痛管理非常好或足够（88.2%）。对术后疼痛控制的满意度与是否获得阿片类药物处方无关（P=0.89）。与未使用阿片类药物的患者相比，使用1剂或更多剂阿片类药物的患者中，认为疼痛管理差或不足的比例更高（19.0%对4.1%；P=0.035）。
许多患者在子宫切除术后出院后未使用术后阿片类镇痛药物，且未出现疼痛管理不佳的情况。外科医生应评估每个患者的情况，并根据需要调整镇痛计划，优化非阿片类药物选择。
