PD19-11 NARCOTIC FREE URETEROSCOPIC LASER LITHOTRIPSY: A PROSPECTIVE RANDOMIZED STUDY

Abstract

You have accessJournal of UrologyCME1 May 2022PD19-11 NARCOTIC FREE URETEROSCOPIC LASER LITHOTRIPSY: A PROSPECTIVE RANDOMIZED STUDY Jacob Bamberger, Blair Gallante, Anna Zampini, William M. Atallah, Johnathan A. Khusid, Areeba S. Sadiq, Alan Yaghoubian, and Mantu Gupta Jacob BambergerJacob Bamberger More articles by this author , Blair GallanteBlair Gallante More articles by this author , Anna ZampiniAnna Zampini More articles by this author , William M. AtallahWilliam M. Atallah More articles by this author , Johnathan A. KhusidJohnathan A. Khusid More articles by this author , Areeba S. SadiqAreeba S. Sadiq More articles by this author , Alan YaghoubianAlan Yaghoubian More articles by this author , and Mantu GuptaMantu Gupta More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002557.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prescription opioid abuse has reached epidemic levels in the US, fueled in part by unused prescription narcotic reservoirs within communities. The aim of this study is to evaluate the efficacy of non-narcotic analgesics and preoperative counseling in managing post-operative pain following ureteroscopic laser lithotripsy (URS). METHODS: Adult patients at a single academic center undergoing URS for urolithiasis were recruited. Exclusion criteria were: pre-existing stent, contradictions to oxycodone, acetaminophen, or ibuprofen, or current prescription analgesic use. After informed consent, subjects were randomized into 3 groups: 1. Narcotic-only (OXY)—15 oxycodone-acetaminophen 5/325mg, 2. NSAID-only (IBU)—15 ibuprofen 600mg, 3. Counseling (CNSL)—15 oxycodone-acetaminophen 5/325mg, 15 ibuprofen 600mg, and preoperative counseling from the surgeon to avoid narcotic if possible. Patients in whom stent placement was deemed unnecessary intraoperatively were excluded. At the time of stent removal subjects completed the Universal Stent Symptom Questionnaire (USSQ) and a pill count was performed. USSQ pain indices and analgesic consumption were primary and secondary study endpoints, respectively. Demographic, operative, and postoperative data were analyzed between the three groups. RESULTS: Of 115 patients who completed the study, 104 were eligible for analysis and 11 were lost to follow-up. No significant differences were noted in patient demographic, clinical or operative characteristics. No differences were noted in mean USSQ pain indices across the three groups. The counseling group used a significantly lower number of OXY pills compared to the narcotic group (2.4 vs. 5.4, p=0.018), and less IBU compared to the non-narcotic group (3.2 vs. 5.7, p=0.008), however no differences in mean total pill count were noted between groups (Table 1). CONCLUSIONS: Our data suggest that patients can achieve equivalent post-operative analgesic satisfaction with non-narcotic pain medication compared to opiates following URS. Further, counseling patients on post-operative pain before surgery can reduce the total number of postoperative narcotic and non-narcotic medications taken.We suggest surgeons strongly consider omission of narcotic prescriptions following non-complicated URS. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e353 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jacob Bamberger More articles by this author Blair Gallante More articles by this author Anna Zampini More articles by this author William M. Atallah More articles by this author Johnathan A. Khusid More articles by this author Areeba S. Sadiq More articles by this author Alan Yaghoubian More articles by this author Mantu Gupta More articles by this author Expand All Advertisement PDF DownloadLoading ...