Abstract
Describe factors that contribute to an increased narcotic medication use after robotic assisted laparoscopic surgery.
Retrospective cohort
Teaching Hospital
All patients undergoing robotic-assisted laparoscopic surgery by gynecologist oncologists at St. Joseph's Hospital and Medical Center over a three year period.
Robotic-assisted laparoscopy by gynecologist oncologists.
Using retrospective chart review, patients that underwent robotic assisted laparoscopic surgery from 2012-2015 in the division of gynecologic oncology were identified. 757 patients were eligible for inclusion in the study. Total narcotic use during the postoperative hospital stay was converted to oral morphine milligram equivalents (OME). Bivariate correlations of total OME narcotics to multiple variables were evaluated using Spearman's rho. The average age, Body Mass Index (BMI), and Length of Stay (LOS) were 53.76 years (17-92), 31.75 (17-56), and 1.56 days (range 0-19), respectively. Increased OME correlated positively with: BMI (Spearman's rho = .077, P = .036), any intraoperative complication (Spearman's rho = .05, P = .886), any postoperative complication (Spearman's rho = .16, P<.0001), length of stay in days (Spearman's rho = .282, P<.0001), procedure time (Spearman's rho .023, P=0.52), and total anesthesia time (Spearman's rho .032). Total OME narcotics were correlated negatively with: age 65 or older (Spearman's rho -.144, P<.0001 and use of patient-controlled analgesia (Spearman's rho =-.185, P < .0001)
Age less than 65 appears to be a predictor for increased requirement of total morphine equivalent medication after robotic assisted laparoscopic surgery; while PCA use had a negative association.