Variations in Opioid Use Following Robotic Radical Prostatectomy in South Florida.

Journal: Journal of endourology
Published Date:

Abstract

Opioid dependency has been a persistent issue in the United States over the past two decades. Increased efforts have been made to reduce opioid prescribing. Our objective was to quantify at-home opioid requirements following radical prostatectomy. Written questionnaires were administered to patients 1 week following robot-assisted laparoscopic radical prostatectomy (RALP). Patients provided data on opioid use, pain levels, and demographic characteristics. Sixty-five patients were included. Median age (interquartile range [IQR]) was 69 (62-72) years. The majority were white (85%) and hispanic (67%). Prescriptions ranged from 6 to 15 pills of 5-mg oxycodone equivalents. Twenty-two percent (145/663) of the prescribed pills in the study were consumed. Fifty-four percent (35/65) of patients did not take opioids. Of the 30 patients who took opioids, median use (IQR) was 4.5 (3-6) pills. Forty-six percent (30/65) reported catheter-related pain. Patients who took opioids reported higher levels of pain. On generalized linear regression, younger age, lower levels of education, and living with a family member were factors associated with increased risk for opioid use (all  < 0.05). Despite the Florida Department of Health's restriction on narcotic prescriptions to 3-day supplies, opioids are still overprescribed in our region. The majority of patients do not require opioids after RALP, and patients who do require an opioid analgesic can be adequately managed with less than 6 pills of 5-mg oxycodone equivalents.

Authors

  • Timothy Demus
    Department of Urology, Mount Sinai Medical Center, Miami Beach, Florida, USA.
  • Diana M Lopategui
    Department of Urology, Mount Sinai Medical Center of Florida, Miami Beach, 33140, FL, USA.
  • Johannes Vieweg
    Department of Surgery, Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA.
  • Jonathan Masel
    Department of Urology, Memorial Healthcare System, Hollywood, Florida, USA.
  • Akshay Bhandari
    Columbia University Division of Urology, Mount Sinai Medical Center, Miami Beach, Florida, USA.
  • Alan M Nieder
    Department of Urology, Mount Sinai Medical Center, Miami Beach, Florida, USA.