Changes in hospital consumption of opioid and non-opioid analgesics after colorectal endometriosis surgery

other OA: closed public-domain-us
Full text JSON View on PubMed View at publisher
AI-generated summary by claude@2026-06, 2026-06-08

Colorectal endometriosis surgery type impacted acetaminophen and nefopam consumption, while robotic surgery increased tramadol use; analgesic practices shifted away from opioids over time.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text

This retrospective study from Tenon University Hospital (Paris) analyzed inpatient postoperative analgesic consumption in 162 patients who underwent colorectal surgery for endometriosis between 2019 and 2021, comparing robotic versus conventional laparoscopy and changes over time. Type of colorectal procedure influenced acetaminophen and nefopam use, and tramadol consumption was higher after robotic surgery than after conventional laparoscopy, while overall analgesic prescribing shifted from tramadol being used by 70% of patients in 2019 to 7.1% in 2021 and ketoprofen increasing to 57% by 2021. History of abdominal surgery and surgery year (2020 or 2021 vs 2019) were the only variables independently associated with opioid use, and the authors report no impact of clinical characteristics or intraoperative findings on opioid consumption. This paper is centrally about endometriosis — it evaluates how inpatient opioid versus non-opioid analgesic consumption changed after colorectal surgery for endometriosis, including procedural and time-period effects.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

The aim of this study was to analyze postoperative consumption of analgesics during hospitalization following colorectal surgery for endometriosis. We conducted a retrospective study at Tenon University Hospital, Paris, France from February 2019 to December 2021. One hundred sixty-two patients underwent colorectal surgery: eighty-nine (55%) by robotic and seventy-three (45%) by conventional laparoscopy. The type of procedure had an impact on acetaminophen and nefopam consumed per day: consumption for colorectal shaving, discoid resection, and segmental resection was, respectively, 2(0.5), 2.1(0.6), 2.4(0.6) g/day (p = 10-3), and 25(7), 30(14), 31(11) mg/day (p = 0.03). The total amount of tramadol consumed was greater following robotic surgery compared with conventional laparoscopy (322(222) mg vs 242(292) mg, p = 0.04). We observed a switch in analgesic consumption over the years: tramadol was used by 70% of patients in 2019 but only by 7.1% in 2021 (p < 10-3); conversely, ketoprofen was not used in 2019, but was consumed by 57% of patients in 2021 (p < 10-3). A history of abdominal surgery (OR = 0.37 (0.16-0.78, p = 0.011) and having surgery in 2020 rather than in 2019 (OR = 0.10 (0.04-0.24, p < 10-3)) and in 2021 than in 2019 (OR = 0.08 (0.03-0.20, p < 10-3)) were the only variables independently associated with the risk of opioid use. We found that neither clinical characteristics nor intraoperative findings had an impact on opioid consumption in this setting, and that it was possible to rapidly modify in-hospital analgesic consumption modalities by significantly reducing opioid consumption in favor of NSAIDS or nefopam.
Full text 10,141 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

The aim of this study was to analyze postoperative consumption of analgesics during hospitalization following colorectal surgery for endometriosis. We conducted a retrospective study at Tenon University Hospital, Paris, France from February 2019 to December 2021. One hundred sixty-two patients underwent colorectal surgery: eighty-nine (55%) by robotic and seventy-three (45%) by conventional laparoscopy. The type of procedure had an impact on acetaminophen and nefopam consumed per day: consumption for colorectal shaving, discoid resection, and segmental resection was, respectively, 2(0.5), 2.1(0.6), 2.4(0.6) g/day (p = 10–3), and 25(7), 30(14), 31(11) mg/day (p = 0.03). The total amount of tramadol consumed was greater following robotic surgery compared with conventional laparoscopy (322(222) mg vs 242(292) mg, p = 0.04). We observed a switch in analgesic consumption over the years: tramadol was used by 70% of patients in 2019 but only by 7.1% in 2021 (p < 10–3); conversely, ketoprofen was not used in 2019, but was consumed by 57% of patients in 2021 (p < 10–3). A history of abdominal surgery (OR = 0.37 (0.16–0.78, p = 0.011) and having surgery in 2020 rather than in 2019 (OR = 0.10 (0.04–0.24, p < 10–3)) and in 2021 than in 2019 (OR = 0.08 (0.03–0.20, p < 10–3)) were the only variables independently associated with the risk of opioid use. We found that neither clinical characteristics nor intraoperative findings had an impact on opioid consumption in this setting, and that it was possible to rapidly modify in-hospital analgesic consumption modalities by significantly reducing opioid consumption in favor of NSAIDS or nefopam. Similar content being viewed by others Data availability The data that support the findings of this study are available from the corresponding author, Dr Adrien Crestani, upon reasonable request.

References

Zondervan KT, Becker CM, Missmer SA (2020) Endometriosis. N Engl J Med 382(13):1244–1256 Weaver J, Chakladar S, Mirchandani K, Liu Z (2022) Surgical and pharmacological treatment patterns in women with endometriosis: a descriptive analysis of insurance claims. J Womens Health (Larchmt) 31(7):1003–1011 Lamvu G, Soliman AM, Manthena SR, Gordon K, Knight J, Taylor HS (2019) Patterns of prescription opioid use in women with endometriosis: evaluating prolonged use, daily dose, and concomitant use with benzodiazepines. Obstet Gynecol 133(6):1120–1130 As-Sanie S, Soliman AM, Evans K, Erpelding N, Lanier RK, Katz NP (2021) Short-acting and long-acting opioids utilization among women diagnosed with endometriosis in the united states: a population-based claims study. J Minim Invasive Gynecol 28(2):297-306.e2 Zhang W, Miller V, Wong M, Loring M, Morris S (2022) Intraoperative factors associated with more postoperative opioid use after laparoscopic hysterectomy. JSLS 26(3):e2022.00028 Delgado SI, Koythong T, Turrentine MA, Sangi-Haghpeykar H, Guan X (2022) Postoperative opioid use for patients with chronic pelvic pain undergoing robotic surgery for resection of endometriosis. J Robotic Surg 16(2):421–427 Hill MV, McMahon ML, Stucke RS, Barth RJJ (2017) Wide variation and excessive dosage of opioid prescriptions for common general surgical procedures. Ann Surg 265(4):709–714 Lovich-Sapola J, Smith CE, Brandt CP (2015) Postoperative pain control. Surg Clin North Am 95(2):301–318 Moawad GN, Klebanoff JS, Muldoon O, North A, Amdur R, Tyan P (2021) Patterns of narcotic utilization in women undergoing hysterectomy for benign indications. J Gynecol Obstet Human Reprod 50(9):102181 Bazot M, Darai E, Hourani R, Thomassin I, Cortez A, Uzan S et al (2004) Deep pelvic endometriosis: MR imaging for diagnosis and prediction of extension of disease. Radiology 232(2):379–389 Roseau G (2014) Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis. World J Gastrointest Endosc 6(11):525–533 Bazot M, Thomassin I, Hourani R, Cortez A, Darai E (2004) Diagnostic accuracy of transvaginal sonography for deep pelvic endometriosis. Ultrasound Obstet Gynecol 24(2):180–185 Daraï E, Ballester M, Chereau E, Coutant C, Rouzier R, Wafo E (2010) Laparoscopic versus laparotomic radical en bloc hysterectomy and colorectal resection for endometriosis. Surg Endosc 24(12):3060–3067 Calculating total daily dose of opioids for safer dosage. 2 Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187–196 Balla A, Quaresima S, Subiela JD, Shalaby M, Petrella G, Sileri P (2018) Outcomes after rectosigmoid resection for endometriosis: a systematic literature review. Int J Colorectal Dis 33(7):835–847 Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H (2021) Surgical outcomes after colorectal surgery for endometriosis: a systematic review and meta-analysis. J Minim Invasive Gynecol 28(3):453–466 Ferrier C, Le Gac M, Kolanska K, Boudy A-S, Dabi Y, Touboul C et al (2022) Comparison of robot-assisted and conventional laparoscopy for colorectal surgery for endometriosis: a prospective cohort study. Int J Med Robot 18(3):e2382 Zilberman S, Ballester M, Touboul C, Chéreau E, Sèbe P, Bazot M et al (2013) Partial colpectomy is a risk factor for urologic complications of colorectal resection for endometriosis. J Minim Invasive Gynecol 20(1):49–55 Ballester M, Belghiti J, Zilberman S, Thomin A, Bonneau C, Bazot M et al (2014) Surgical and clinical impact of extraserosal pelvic fascia removal in segmental colorectal resection for endometriosis. J Minim Invasive Gynecol 21(6):1041–1048 Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N et al (2019) Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS®) society recommendations: 2018. World J Surg 43(3):659–695 Podda M, Saverio SD, Davies RJ, Atzeni J, Balestra F, Virdis F et al (2020) Prophylactic intra-abdominal drainage following colorectal anastomoses. A systematic review and meta-analysis of randomized controlled trials. Am J Surg 219(1):164–174 Mangalath AS, Kumar L, Sawant AB, Kesavan R, Ravindran G, Sunil R (2021) Comparison of analgesic requirements in robot-assisted versus conventional laparoscopic abdominal surgeries. J Anaesthesiol Clin Pharmacol 37(1):79–84 Jin J, Chen Q, Min S, Du X, Zhang D, Qin P (2021) Prevalence and predictors of chronic postsurgical pain after colorectal surgery: a prospective study. Colorectal Dis 23(7):1878–1889 Laganà AS, Rosa VLL, Rapisarda AMC, Valenti G, Sapia F, Chiofalo B et al (2017) Anxiety and depression in patients with endometriosis: impact and management challenges. IJWH 9:323–330 Lindberg M, Franklin O, Svensson J, Franklin KA (2020) Postoperative pain after colorectal surgery. Int J Colorectal Dis 35(7):1265–1272 Shah A (2017) Characteristics of initial prescription episodes and likelihood of long-term opioid use—United States, 2006–2015. MMWR Morb Mortal Wkly Rep [Internet] 2017 [cited 2022 Dec 10] 66. Available from: https://www.facebook.com/CDCMMWR Use and abuse of opioid analgesics - February 2019. 52 Evans MS, Lysakowski C, Tramèr MR (2008) Nefopam for the prevention of postoperative pain: quantitative systematic review. Br J Anaesth 101(5):610–617 Moffat AC, Kenny GN, Prentice JW (1990) Postoperative nefopam and diclofenac. Evaluation of their morphine-sparing effect after upper abdominal surgery. Anaesthesia 45(4):302–305 Wick EC, Grant MC, Wu CL (2017) Postoperative multimodal analgesia pain management with nonopioid analgesics and techniques: a review. JAMA Surg 152(7):691–697 Grahn O, Lundin M, Chapman SJ, Rutegård J, Matthiessen P, Rutegård M (2022) Postoperative nonsteroidal anti-inflammatory drugs in relation to recurrence, survival and anastomotic leakage after surgery for colorectal cancer. Colorectal Dis 24(8):933–942 Kverneng Hultberg D, Angenete E, Lydrup M-L, Rutegård J, Matthiessen P, Rutegård M (2017) Nonsteroidal anti-inflammatory drugs and the risk of anastomotic leakage after anterior resection for rectal cancer. Eur J Surg Oncol 43(10):1908–1914 Milne TGE, Jaung R, O’Grady G, Bissett IP (2018) Nonsteroidal anti-inflammatory drugs reduce the time to recovery of gut function after elective colorectal surgery: a systematic review and meta-analysis. Colorectal Dis 20(8):O190–O198 Gupta A, Bah M (2016) NSAIDs in the treatment of postoperative pain. Curr Pain Headache Rep 20(11):62 Kanellos P, Nirgianakis K, Siegenthaler F, Vetter C, Mueller MD, Imboden S (2021) Postoperative pain is driven by preoperative pain, not by endometriosis. J Clin Med 10(20):4727 Funding No funds, grants, or other support were received. Author information Authors and Affiliations Contributions AB, MLG, and YD participated in the data collection; AC carried out the statistics; KK, CF, and SB participated in the writing of the article; ED validated the final version. Each author read the manuscript and approved its submission. Corresponding author Ethics declarations Conflict of interest The authors have no relevant financial or non-financial interests to disclose. Consent to participate Information consent was obtained from all individual participants 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 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Crestani, A., Bibaoune, A., Le Gac, M. et al. Changes in hospital consumption of opioid and non-opioid analgesics after colorectal endometriosis surgery. J Robotic Surg 17, 2703–2710 (2023). https://doi.org/10.1007/s11701-023-01691-y Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s11701-023-01691-y

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

MeSH descriptors

Analgesics, Non-Narcotic Analgesics, Non-Narcotic Analgesics, Non-Narcotic Analgesics, Non-Narcotic Analgesics, Non-Narcotic Analgesics, Non-Narcotic Analgesics, Non-Narcotic Analgesics, Non-Narcotic Analgesics, Non-Narcotic Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Neoplasms Colorectal Surgery Colorectal Surgery Colorectal Surgery

Citation neighborhood (no data yet)

We don't have any in-corpus citations linked to this paper yet. The paper's references may be in our DB but unresolved to ``paper_id`` (resolution happens at ingest when the cited DOI matches a row we already have). Run the cross-source citation reconcile pass to retry.

Source provenance

europepmc
last seen: 2026-06-12T06:13:51.797165+00:00
pubmed
last seen: 2026-05-29T00:33:26.437191+00:00
unpaywall
last seen: 2026-05-14T19:30:52.867331+00:00
License: public-domain-us · commercial use OK · attribution required
Courtesy of the U.S. National Library of Medicine