07: ICE‐T postoperative multimodal pain regimen compared to the standard regimen in vaginal pelvic reconstructive surgery: a multicenter randomized controlled trial

Abstract

dismissal were evaluated by telephone call two weeks after surgery. Postoperative opioid prescribing and use were recorded after conversion to Oral Morphine Equivalents (OME). RESULTS: Overall, 96 women were included, 57 in the initial baseline cohort, and 39 following implementation of the prescribing recommendations. In the initial cohort, 3607/11007 mg (32.8%) of the prescribed OME were consumed. Following implementation of the prescribing recommendations, median OME prescribed decreased from 200 mg OME (IQR 150,225) to 112.5 mg OME (IQR 22.5,112.5; p <0.0001). The total OME prescribed decreased by 45% when compared with the volume that would have been prescribed before implementing the recommendations. The amount of leftover opioids per patient significantly decreased as well (p<0.0001). Pain medication refills increased after the intervention (18% vs 3.5%; p1⁄40.03), while satisfaction scores were similar in both cohorts (p1⁄40.87). CONCLUSION: At baseline, overprescribing of opioids following pelvic organ prolapse surgery was common. By utilizing procedure-specific opioid prescribing recommendations we decreased the number of opioids prescribed at hospital dismissal by roughly half. Decreased opioid prescribing did not adversely impact patient satisfaction.