Perioperative Narcotic Trends in Women Undergoing Minimally Invasive Hysterectomy for Benign Indications

Abstract

Study Objective Evaluate the utilization patterns for narcotic medication both intraoperatively and postoperatively at the time of benign minimally invasive hysterectomy, specifically as they relate to the opioid epidemic. Design Retrospective cohort study. Setting A single academic university hospital. Patients or Participants Women undergoing minimally invasive hysterectomy for benign indications. Interventions Laparoscopic or Robotic-Assisted hysterectomy. Measurements and Main Results 651 hysterectomies were included in the analysis between 2012 and 2018. For consistency all narcotics administered intraoperatively and in immediate postoperative period were converted to mean morphine equivalents (MME). For the entire cohort the mean age was 44.5 ± 7.4 years and the mean Body Mass Index (BMI; Kg/m2) was 32.1 ± 7.6. Of these, 377 hysterectomies (57.9%) were performed with robotic assistance and the remainder (42.1%) were performed using conventional laparoscopy. A statistically significant inverse relationship was found between the year of surgery and perioperative narcotic usage (p=.007). In all hysterectomies analyzed yearly MME use decreased over time (p Conclusion Perioperative narcotic use has down trended over time for patients undergoing minimally invasive hysterectomy. Hysterectomy performed with robotic assistance was associated with lower postoperative narcotic use compared to conventional laparoscopy.