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Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis
Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive. Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge. 641...
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| Published in: | The American journal of surgery 2024-06, Vol.232, p.131-137 |
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| container_title | The American journal of surgery |
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| creator | Diaz, Sarah Brockhaus, Kara K. Bobel, Matthew C. Colom, Sara M. Ramm, Carole Cleary, Robert K. |
| description | Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive.
Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge.
641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly higher NPS for the Benign than the Malignant group preoperative and postoperative day 0 (after surgery), 1, 2, and 3 (all p ≤ 0.001). Opioids prescribed at discharge were significantly higher in the Benign group (60.0% vs 51.1%, p = 0.018). After regression analysis, there was no longer a significant difference in NPS (B = 0.703, p = 0.095) and opioids prescribed between groups [OR = 0.803 (95%CI 0.586, 1.1), p = 0.173].
Pain and opioids prescribed at discharge are not significantly different between benign and malignant diseases in an enhanced recovery pain management pathway that maximizes non-opioid multimodal analgesic strategies.
[Display omitted]
•Pain after colorectal surgery is not higher for benign versus malignant disease.•Opioids prescribed at discharge are not more for benign versus malignant disease.•Enhanced recovery pathways should target other risk variables for opioid needs. |
| doi_str_mv | 10.1016/j.amjsurg.2024.01.034 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2928245003</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002961024000369</els_id><sourcerecordid>2928245003</sourcerecordid><originalsourceid>FETCH-LOGICAL-c341t-531820a7805f8fe4a76b61d0c38d8edb97d2d65f4e17d18e826445da391d2b023</originalsourceid><addsrcrecordid>eNqFkcFu1DAQhi0EokvhEUCWuHBJGNtx4nBBVQUFqRIc4Gw58WTlKLG3nqRS375ZduHApSd7pO__bc3H2FsBpQBRfxxLN4-05n0pQVYliBJU9YzthGnaQhijnrMdAMiirQVcsFdE4zYKUamX7EIZVWutYcfufroQuYuep0NIwfOVkLthwcz7NKWM_eImnpG2S0iRDynzDmPYR36PmVbis5u2ycWF-0DoCD_xK04h7ifkIdISlvVP0kU3PVCg1-zF4CbCN-fzkv3--uXX9bfi9sfN9-ur26JXlVgKrYSR4BoDejADVq6pu1p46JXxBn3XNl76Wg8VisYLg0bWVaW9U63wsgOpLtmHU-8hp7sVabFzoB6nyUVMK1nZSiMrDaA29P1_6JjWvP2XrAKttJDGHAv1iepzIso42EMOs8sPVoA9OrGjPTuxRycWhN2cbLl35_a1m9H_S_2VsAGfTwBu67gPmC31AWOPPhz3b30KTzzxCFf7oJg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3053512882</pqid></control><display><type>article</type><title>Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis</title><source>ScienceDirect Freedom Collection</source><creator>Diaz, Sarah ; Brockhaus, Kara K. ; Bobel, Matthew C. ; Colom, Sara M. ; Ramm, Carole ; Cleary, Robert K.</creator><creatorcontrib>Diaz, Sarah ; Brockhaus, Kara K. ; Bobel, Matthew C. ; Colom, Sara M. ; Ramm, Carole ; Cleary, Robert K.</creatorcontrib><description>Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive.
Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge.
641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly higher NPS for the Benign than the Malignant group preoperative and postoperative day 0 (after surgery), 1, 2, and 3 (all p ≤ 0.001). Opioids prescribed at discharge were significantly higher in the Benign group (60.0% vs 51.1%, p = 0.018). After regression analysis, there was no longer a significant difference in NPS (B = 0.703, p = 0.095) and opioids prescribed between groups [OR = 0.803 (95%CI 0.586, 1.1), p = 0.173].
Pain and opioids prescribed at discharge are not significantly different between benign and malignant diseases in an enhanced recovery pain management pathway that maximizes non-opioid multimodal analgesic strategies.
[Display omitted]
•Pain after colorectal surgery is not higher for benign versus malignant disease.•Opioids prescribed at discharge are not more for benign versus malignant disease.•Enhanced recovery pathways should target other risk variables for opioid needs.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2024.01.034</identifier><identifier>PMID: 38365550</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Analgesics ; Benign ; Colon ; Colorectal ; Demographics ; Diabetes ; Diverticulitis ; Hospitals ; Hypertension ; Inflammatory bowel disease ; Kidneys ; Laparoscopy ; Length of stay ; Multiple regression analysis ; Narcotics ; Opioid ; Opioids ; Ostomy ; Pain ; Pain management ; Patients ; Prescriptions ; Rectum ; Risk factors ; Robotics ; Standard deviation ; Statistical analysis ; Surgery ; Surgical anastomosis ; Tobacco ; Variables</subject><ispartof>The American journal of surgery, 2024-06, Vol.232, p.131-137</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><rights>2024. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c341t-531820a7805f8fe4a76b61d0c38d8edb97d2d65f4e17d18e826445da391d2b023</cites><orcidid>0000-0002-3549-6283 ; 0000-0003-2488-996X ; 0000-0002-9027-1693 ; 0009-0007-1670-3412</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38365550$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Diaz, Sarah</creatorcontrib><creatorcontrib>Brockhaus, Kara K.</creatorcontrib><creatorcontrib>Bobel, Matthew C.</creatorcontrib><creatorcontrib>Colom, Sara M.</creatorcontrib><creatorcontrib>Ramm, Carole</creatorcontrib><creatorcontrib>Cleary, Robert K.</creatorcontrib><title>Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive.
Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge.
641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly higher NPS for the Benign than the Malignant group preoperative and postoperative day 0 (after surgery), 1, 2, and 3 (all p ≤ 0.001). Opioids prescribed at discharge were significantly higher in the Benign group (60.0% vs 51.1%, p = 0.018). After regression analysis, there was no longer a significant difference in NPS (B = 0.703, p = 0.095) and opioids prescribed between groups [OR = 0.803 (95%CI 0.586, 1.1), p = 0.173].
Pain and opioids prescribed at discharge are not significantly different between benign and malignant diseases in an enhanced recovery pain management pathway that maximizes non-opioid multimodal analgesic strategies.
[Display omitted]
•Pain after colorectal surgery is not higher for benign versus malignant disease.•Opioids prescribed at discharge are not more for benign versus malignant disease.•Enhanced recovery pathways should target other risk variables for opioid needs.</description><subject>Analgesics</subject><subject>Benign</subject><subject>Colon</subject><subject>Colorectal</subject><subject>Demographics</subject><subject>Diabetes</subject><subject>Diverticulitis</subject><subject>Hospitals</subject><subject>Hypertension</subject><subject>Inflammatory bowel disease</subject><subject>Kidneys</subject><subject>Laparoscopy</subject><subject>Length of stay</subject><subject>Multiple regression analysis</subject><subject>Narcotics</subject><subject>Opioid</subject><subject>Opioids</subject><subject>Ostomy</subject><subject>Pain</subject><subject>Pain management</subject><subject>Patients</subject><subject>Prescriptions</subject><subject>Rectum</subject><subject>Risk factors</subject><subject>Robotics</subject><subject>Standard deviation</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Surgical anastomosis</subject><subject>Tobacco</subject><subject>Variables</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkcFu1DAQhi0EokvhEUCWuHBJGNtx4nBBVQUFqRIc4Gw58WTlKLG3nqRS375ZduHApSd7pO__bc3H2FsBpQBRfxxLN4-05n0pQVYliBJU9YzthGnaQhijnrMdAMiirQVcsFdE4zYKUamX7EIZVWutYcfufroQuYuep0NIwfOVkLthwcz7NKWM_eImnpG2S0iRDynzDmPYR36PmVbis5u2ycWF-0DoCD_xK04h7ifkIdISlvVP0kU3PVCg1-zF4CbCN-fzkv3--uXX9bfi9sfN9-ur26JXlVgKrYSR4BoDejADVq6pu1p46JXxBn3XNl76Wg8VisYLg0bWVaW9U63wsgOpLtmHU-8hp7sVabFzoB6nyUVMK1nZSiMrDaA29P1_6JjWvP2XrAKttJDGHAv1iepzIso42EMOs8sPVoA9OrGjPTuxRycWhN2cbLl35_a1m9H_S_2VsAGfTwBu67gPmC31AWOPPhz3b30KTzzxCFf7oJg</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>Diaz, Sarah</creator><creator>Brockhaus, Kara K.</creator><creator>Bobel, Matthew C.</creator><creator>Colom, Sara M.</creator><creator>Ramm, Carole</creator><creator>Cleary, Robert K.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3549-6283</orcidid><orcidid>https://orcid.org/0000-0003-2488-996X</orcidid><orcidid>https://orcid.org/0000-0002-9027-1693</orcidid><orcidid>https://orcid.org/0009-0007-1670-3412</orcidid></search><sort><creationdate>20240601</creationdate><title>Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis</title><author>Diaz, Sarah ; Brockhaus, Kara K. ; Bobel, Matthew C. ; Colom, Sara M. ; Ramm, Carole ; Cleary, Robert K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c341t-531820a7805f8fe4a76b61d0c38d8edb97d2d65f4e17d18e826445da391d2b023</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Analgesics</topic><topic>Benign</topic><topic>Colon</topic><topic>Colorectal</topic><topic>Demographics</topic><topic>Diabetes</topic><topic>Diverticulitis</topic><topic>Hospitals</topic><topic>Hypertension</topic><topic>Inflammatory bowel disease</topic><topic>Kidneys</topic><topic>Laparoscopy</topic><topic>Length of stay</topic><topic>Multiple regression analysis</topic><topic>Narcotics</topic><topic>Opioid</topic><topic>Opioids</topic><topic>Ostomy</topic><topic>Pain</topic><topic>Pain management</topic><topic>Patients</topic><topic>Prescriptions</topic><topic>Rectum</topic><topic>Risk factors</topic><topic>Robotics</topic><topic>Standard deviation</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Surgical anastomosis</topic><topic>Tobacco</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Diaz, Sarah</creatorcontrib><creatorcontrib>Brockhaus, Kara K.</creatorcontrib><creatorcontrib>Bobel, Matthew C.</creatorcontrib><creatorcontrib>Colom, Sara M.</creatorcontrib><creatorcontrib>Ramm, Carole</creatorcontrib><creatorcontrib>Cleary, Robert K.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Diaz, Sarah</au><au>Brockhaus, Kara K.</au><au>Bobel, Matthew C.</au><au>Colom, Sara M.</au><au>Ramm, Carole</au><au>Cleary, Robert K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>232</volume><spage>131</spage><epage>137</epage><pages>131-137</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive.
Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge.
641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly higher NPS for the Benign than the Malignant group preoperative and postoperative day 0 (after surgery), 1, 2, and 3 (all p ≤ 0.001). Opioids prescribed at discharge were significantly higher in the Benign group (60.0% vs 51.1%, p = 0.018). After regression analysis, there was no longer a significant difference in NPS (B = 0.703, p = 0.095) and opioids prescribed between groups [OR = 0.803 (95%CI 0.586, 1.1), p = 0.173].
Pain and opioids prescribed at discharge are not significantly different between benign and malignant diseases in an enhanced recovery pain management pathway that maximizes non-opioid multimodal analgesic strategies.
[Display omitted]
•Pain after colorectal surgery is not higher for benign versus malignant disease.•Opioids prescribed at discharge are not more for benign versus malignant disease.•Enhanced recovery pathways should target other risk variables for opioid needs.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38365550</pmid><doi>10.1016/j.amjsurg.2024.01.034</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3549-6283</orcidid><orcidid>https://orcid.org/0000-0003-2488-996X</orcidid><orcidid>https://orcid.org/0000-0002-9027-1693</orcidid><orcidid>https://orcid.org/0009-0007-1670-3412</orcidid></addata></record> |
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| ispartof | The American journal of surgery, 2024-06, Vol.232, p.131-137 |
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| source | ScienceDirect Freedom Collection |
| subjects | Analgesics Benign Colon Colorectal Demographics Diabetes Diverticulitis Hospitals Hypertension Inflammatory bowel disease Kidneys Laparoscopy Length of stay Multiple regression analysis Narcotics Opioid Opioids Ostomy Pain Pain management Patients Prescriptions Rectum Risk factors Robotics Standard deviation Statistical analysis Surgery Surgical anastomosis Tobacco Variables |
| title | Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis |
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