Satisfaction with Opioid Use after Minor Gynecologic Surgery: A Pilot Prospective Study

Abstract

<h3>Study Objective</h3> The primary objectives of this study are to 1) describe the current postoperative opioid prescribing practices following minor gynecologic and urogynecologic surgery and 2) determine patients' satisfaction with these practices. <h3>Design</h3> prospective cohort study. <h3>Setting</h3> academic medical center. <h3>Patients or Participants</h3> patients undergoing minor gynecologic and urogynecologic surgeries between September 2018 and May 2019. Patients were surveyed preoperatively (within 1 week prior to surgery), on postoperative day (POD) 1 or 2, and finally at POD 14. Survey instruments were completed via RedCap. The proportions of patients receiving, filling and using an opioid prescription were estimated using RedCap responses to surveys completed on postoperative day 1-2 and postoperative day 14. All data analyses were performed using SAS 9.4 (Cary, NC). <h3>Interventions</h3> None. <h3>Measurements and Main Results</h3> 151 patients underwent a minor gynecologic surgery. Among these 81 (54%) received an opioid prescription. Among the women who received an opioid prescription, 68 of these patients reported filling the script (84%) and 55 of those who filled an opioid prescription reported using any opioid (81%). The median MME of cumulative opioid use by POD 14 was 35 (15-75) compared to median MME prescribed 75 (75-112.5). There were no differences in overall satisfaction scores (qualitative or quantitative) between participants by opioid prescription or fill status. There was no association between preoperative anxiety (BAI) and opioid prescription or use. <h3>Conclusion</h3> More than one half of all patients undergoing minor gynecologic and urogynecologic procedures were prescribed an opioid. Our results suggest that opioids are overprescribed, in that some women never filled their opioid prescription and many of those who did fill the prescription reported the quantity exceeded their needs. Opioid prescription was not associated with a difference in patient reported satisfaction with quality of surgical care.