MP03-05 OPIOID ALTERNATIVE OUTPATIENT MALE ANTERIOR URETHROPLASTY PAIN PATHWAY: EVIDENCE FOR CHANGE

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I (MP03)1 Sep 2021MP03-05 OPIOID ALTERNATIVE OUTPATIENT MALE ANTERIOR URETHROPLASTY PAIN PATHWAY: EVIDENCE FOR CHANGE Bridget Findlay, Elizabeth Bearrick, Kevin Hebert, Matthew Ziegelmann, Katherine Theisen, and Boyd Viers Bridget FindlayBridget Findlay More articles by this author , Elizabeth BearrickElizabeth Bearrick More articles by this author , Kevin HebertKevin Hebert More articles by this author , Matthew ZiegelmannMatthew Ziegelmann More articles by this author , Katherine TheisenKatherine Theisen More articles by this author , and Boyd ViersBoyd Viers More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001964.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Surgeons play a central role in the opioid epidemic. We aim to evaluate efficacy of standardized perioperative pain management pathway and postoperative opioid requirements in men undergoing outpatient anterior urethroplasty at our institution. METHODS: Patients undergoing outpatient anterior urethroplasty by a single surgeon from August 2017 – January 2021 were prospectively followed. Standardized nonopioid pathways were implemented based on location (penile vs. bulbar) and need for buccal mucosa graft (BMG). A practice change in October 2018 transitioned to tramadol, an opioid alternative, from oxycodone postoperatively and liposomal bupivacaine from 0.25% bupivacaine intraoperatively. Postoperative non-validated questionnaires included 72-hour pain level (Likert 0-10), pain management satisfaction (Likert 1-6), and opioid/opioid alternative consumption. RESULTS: A total of 116 men underwent outpatient anterior urethroplasty during the study period. Patient characteristics are described in Table 1. One third of patients did not use opioid/opioid alternatives postoperatively and nearly 78% of patients used ≤5 tabs. The only predictor for use >5 tabs was preoperative opioid use (75% vs. 25%, p=0.0002). Overall, there was no difference in pain satisfaction, pain score, or amount opioid consumed between opioid and local anesthetic types. CONCLUSIONS: An opioid alternative regimen is as efficacious as an opioid regimen in male anterior urethral surgery. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e23-e23 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bridget Findlay More articles by this author Elizabeth Bearrick More articles by this author Kevin Hebert More articles by this author Matthew Ziegelmann More articles by this author Katherine Theisen More articles by this author Boyd Viers More articles by this author Expand All Advertisement Loading ...