“Opioid free colorectal surgery: Outcomes of successful non-opiate colorectal surgery in a rural community teaching hospital”

Abstract

BackgroundOpiates present challenges due to side effects, including prolonged hospitalization and delayed bowel function. Enhanced Recovery After Surgery (ERAS) protocols advocate for multimodal pain management, yet few studies explore entirely non-opiate approaches. Methods134 elective ERAS colorectal surgery patients were reviewed from January 2019 to June 2020 ​at a single institution, with surgery performed by a single surgeon. Endpoints were pain scores, length of stay (LOS), and mortality. ResultsForty patients were included in the non-opiate cohort. Mann Whitney-U test found that postoperatively, non-opiate patients spent significantly less time in moderate or severe pain (p ​< ​.001). There was no significant difference between study groups (non-opiate and opiate) for the no or mild pain categories, LOS, or mortality. Risk factors for opiate use were younger age and prior opiate use. Gender, ASA class, stoma creation, malignancy, and surgical approach were not associated with increased opiates. ConclusionNon-opiate approaches in colorectal surgery are feasible and comparable to opiate regimens in our patient cohort.