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• W4295299074 abstract "<b>Objectives:</b> The purpose of this study was to determine if there was a difference in postoperative opioid use based on race after surgery for gynecologic cancers. <b>Methods:</b> The electronic medical record (EMR) was used to identify patients undergoing major surgery within the Division of Gynecologic Oncology at a single institution from July 1, 2019, to June 30, 2020. Descriptive data and prognostic factors were collected. The EMR and state prescription drug monitoring systems were used to collect information on filled opioid prescriptions. Opioid use was standardized to morphine milligram equivalents (MMEs). The effect of perioperative enhanced recovery after surgery (ERAS) implementation on postoperative opioid use was assessed. SAS Version 9.4 was used for statistical analyses. <b>Results:</b> A total of 160 patients met the inclusion criteria. Among the patients, 51.9% were White, 41.2% Black, and 6.9% others. Of the included patients, 81% received some component of ERAS. Implementation of ERAS components was variable, with 58.1% of patients receiving preoperative acetaminophen, 52.5% receiving preoperative gabapentin, and 54.7% receiving pre or postoperative Transversus Abdominis Plane (TAP) blocks. Analyses compared postoperative opioid use between Blacks and White patients. There was no difference in opioid use during the last 24 hours of hospitalization (25.5 vs 21.7 MMEs, p=0.46). There was a trend towards increased opioids prescribed at discharge (343 vs 206 MMEs, p=0.086) and total opioids prescribed in the 30-day postoperative period (538 vs 327 MMEs, p=0.59) in Black than White patients. There was no difference in ERAS implementation between Black and White patients. For Black patients, preoperative acetaminophen was associated with a statistically significant reduction in inpatient opioid use in the last 24 hours of hospitalization (17.8 vs 36.7 MMEs, p=0.041) and opioids prescribed at discharge (189 vs 568 MMEs, p=0.047). However, this difference was not observed for White patients. Preoperative gabapentin demonstrated similar trends. The effect of TAP blocks on postoperative narcotic use was not significant in either group. <b>Conclusions:</b> Preoperative acetaminophen use in Black patients was associated with decreased postoperative opioid use. This information can be used to improve counseling for patients on home-going pain management regimens." @default.
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• W4295299074 date "2022-08-01" @default.
• W4295299074 modified "2023-09-25" @default.
• W4295299074 title "Evaluating differences in enhanced recovery after surgery (ERAS) implementation and its effects on opioid use by race (571)" @default.
• W4295299074 doi "https://doi.org/10.1016/s0090-8258(22)01792-9" @default.
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