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

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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.

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Data availability

The data that support the findings of this study are available from the corresponding author, Dr Adrien Crestani, upon reasonable request.

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Funding

No funds, grants, or other support were received.

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, 75020, Paris, France

    Adrien Crestani, Marjolaine Le Gac, Yohann Dabi, Kamila Kolanska, Clément Ferrier, Sofiane Bendifallah, Cyril Touboul & Emile Darai

  2. Department of Pharmacy, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Sorbonne University, 75020, Paris, France

    Amine Bibaoune & Emile Darai

  3. UMRS 938, Centre de Recherche Saint Antoine, Faculté de Médecine Sorbonne Université, 75012, Paris, France

    Kamila Kolanska

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  1. Adrien Crestani
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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.

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Correspondence to Adrien Crestani.

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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

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