Postoperative opioid use for patients with chronic pelvic pain undergoing robotic surgery for resection of endometriosis

We aimed to identify the amount of opioids used in the postoperative setting for patients with a history of chronic pelvic pain undergoing robotic surgical excision of endometriosis and compare this to patients undergoing benign robotic gynecologic surgery for other indications. We conducted a retrospective cohort study in an urban academic university hospital from January 2019 to March 2020. Data regarding opioid use was collected via a patient-reported survey that was given at the 3 weeks follow-up visit. Data regarding opioid use was compared to patients undergoing robotic surgery for other benign gynecologic indications. Our study included 158 patients, 119 undergoing surgery for endometriosis and 39 patients undergoing robotic surgery for other benign gynecologic indications. Patients undergoing surgery for endometriosis used on average 105.9 morphine milligram equivalents (MME), equivalent to 14 tabs of oxycodone 5 mg. There was no statistically significant difference in the amount of opioids used postoperatively based on stage of endometriosis or need for hysterectomy. Patients undergoing surgery for other benign indications used on average 49.4 MME, equivalent to 6 tabs of oxycodone 5 mg. The difference in amount of opioids used between patients with and without endometriosis was statistically significant. In conclusion, patients undergoing robotic surgery for endometriosis used over two times as many opioids postoperatively as patients without endometriosis and have a higher perceived postoperative pain. Providers should be aware of this difference in order to provide better pain control for this patient population. Similar content being viewed by others Availability of data and material The data that support the findings of this study are available on request from the corresponding author, XG. The data are not publicly available due to their containing information that could compromise the privacy of research participants. Code availability The codes for this study are available on request from the corresponding author, XG. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

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Author information Authors and Affiliations Contributions All authors named on this submission made substantial contributions to the study. Material preparation, data collection and analysis were by SD, TK, MT, and XG. HS-H performed all statistical analysis. The first draft of the manuscript was written by SD and all authors commented on previous versions of the manuscript and approved the final manuscript. Corresponding author Ethics declarations Conflict of interest Dr. S Delgado, MD, T Koythong, MD, M Turrentine, MD, H Sangi-Haghpeykar, X Guan, MD declare that they have no financial disclosures or conflicts of interests. Ethics approval This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the IRB for Baylor College of Medicine. Approval Date: 3/30/2020. IRB Number: H-47180. Informed consent All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Delgado, S.I., Koythong, T., Turrentine, M.A. et al. Postoperative opioid use for patients with chronic pelvic pain undergoing robotic surgery for resection of endometriosis. J Robotic Surg 16, 421–427 (2022). https://doi.org/10.1007/s11701-021-01259-8 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s11701-021-01259-8