A multidisciplinary opioid-reduction pathway for robotic prostatectomy: outcomes at year one
Authors' conclusion
These findings underscore the effectiveness of a multidisciplinary approach to reduce opioids.
Study context
- Population
- Patients undergoing robotic prostatectomy, single centre2:1 propensity matched
- Exposure
- Post vs Pre
- Outcome
- Post-operative opioid use (OME)
- Follow-up
- Duration of the hospitalization
Methodological detailssingle-centre, 2:1 propensity matched, pre- vs post-implementation
- Single-centre
- 2:1 propensity matched
- Pre- vs post-implementation
Main finding
As reported in the abstract
P = 0.002
Observational data: associations, not effects.
Further findings
Intraoperative opioid use (oral morphine equivalents (OME))
- Pre- vs post-pathway, significantly decreased
- 38.2 mg (28.3) vs. 18.0 mg (40.4) oral morphine equivalents (OME), p < .001
- 2:1 propensity matched
Postop opioid use, subgroup receiving intraop opioids (n = 152) · post-operative period
- Pre- vs post-pathway, fewer opioids
- 47.0 mg (47.7) vs. 32.4 mg (40.6) OME, p = 0.001
Postop opioid use, subgroup receiving no intraop opioids (n = 34) · post-operative period
- Pre- vs post-pathway, fewer opioids
- 62.4 mg (62.9) vs. 35.8 mg (27.7) OME, p = 0.13
Time to discharge from PACU, subgroup receiving intraop opioids
- Pre- vs post-pathway, reduced
- 215 min (199) vs. 167 min (122), p < 0.003
Time to discharge from PACU, subgroup receiving no intraop opioids
- Pre- vs post-pathway, reduced
- 253 min (270) vs. 167 min (105), p = 0.028
Time until meeting PACU discharge criteria
- Pre- vs post-pathway
- 221 min (205) vs. 170 min (120), p = 0.001
Hospital length of stay (LOS)
- Pre- vs post-pathway, significantly reduced
- 1.4 days (1.3) vs. 1.2 days (0.8), p = 0.005
Hospital LOS, subgroup receiving intraop opioids
- Pre- vs post-pathway, reduced
- 1.5 days (1.4) vs. 1.2 days (0.8), p = 0.0047
Hospital LOS, subgroup receiving no intraop opioids
- Pre- vs post-pathway, reduced
- 1.7 days (1.6) vs. 1.3 days (0.9), p = 0.0583
Average pain scores during PACU and post-PACU until discharge
- Not statistically different between cohorts
Original publication
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