Introduction: Our Urology Department started an initiative to reduce opioid prescribing among patients undergoing prostatectomy and nephrectomy. To assess the effect of this reduction in opioids on patient-reported pain outcomes, we employed a validated questionnaire and compared the results of patients who received opioid and opioid-free pain management following prostatectomy or nephrectomy.
Methods: We distributed the American Pain Society Patient Outcome Questionnaire to patients during their first postoperative office visit following prostatectomy and nephrectomy from January through June 2019. We supplemented and paired questionnaire data with patient demographics, postoperative pain prescriptions, hospital course, and surgeon characteristics. Questionnaire results between patients receiving opioid and opioid-free pain management were compared with Wilcoxon rank-sum tests.
Results: A total of 99 patients completed the questionnaire following prostatectomy (n=57) or nephrectomy (n=42), with an overall response rate of 32%. There were no significant differences in measured pain outcomes between patients who received opioid or opioid-free pain management. Amount of pain experienced, time in pain and effect of pain on recovery and mood were all statistically similar (p>0.05) between groups following both prostatectomy and nephrectomy (Figure 1).
Conclusions: Based on patient questionnaire responses, patients can be managed without opioids to no deleterious effect on pain control. These results support the adoption of opioid-free prostatectomy and nephrectomy for most patients. Source of
Funding: Shadyside Hospital Foundation, Henry L. Hillman Foundation