Multimodal pain control is associated with reduced hospital stay following open abdominal hysterectomy

Joseph Santoso, Michael A. Ulm, Patrick W. Jennings, Jim Wan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective To study the association of a multimodal pain protocol (MMPC) and reduced hospital stay after open abdominal hysterectomy. Study design The study design was a comparison of a prospective cohort with a retrospective historical control. We enrolled endometrial cancer patients undergoing open abdominal hysterectomy with lymphadenectomy by the same surgeon. Control patients from 2008 to 2010 who received morphine PCA alone were compared with a similar demographic group of patients from 2011 to 2013 who received MMPC. MMPC consisted of gabapentin (900 mg PO) and acetaminophen (1 g IV) administered 45-60 min preoperatively. The surgical site was injected with bupivacaine with 0.5% epinephrine prior to incision. The postoperative pain control regimen consisted of gabapentin (300 mg PO every 6 h), acetaminophen (1 g IV every 8 h for 24 h postoperatively), ketorolac (15 mg IV every 6 h for 48 h postoperatively), morphine PCA (2 mg IV every 10 min, no basal rate) and oxycodone/acetaminophen (10/325 mg PO every 6 h as needed). Results Length of hospital stay (LOH) of the study cohort (N = 105 with MMPC) was compared with the historical with postoperative morphine alone (N = 113 without MMPC). There were no differences in demographic, uterine cancer stage, or comorbidities between the two arms. The LOH was 1.6 days for patients receiving MMPC and 3.3 days for patients who received morphine alone (P < 0.001). Conclusion Multimodal pain control is associated with significantly reduced hospital stay after open abdominal hysterectomy.

Original languageEnglish (US)
Pages (from-to)48-51
Number of pages4
JournalEuropean Journal of Obstetrics Gynecology and Reproductive Biology
Volume183
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Hysterectomy
Length of Stay
Pain
Morphine
Passive Cutaneous Anaphylaxis
Acetaminophen
Demography
Ketorolac
Uterine Neoplasms
Bupivacaine
Endometrial Neoplasms
Postoperative Pain
Lymph Node Excision
Epinephrine
Comorbidity
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Multimodal pain control is associated with reduced hospital stay following open abdominal hysterectomy. / Santoso, Joseph; Ulm, Michael A.; Jennings, Patrick W.; Wan, Jim.

In: European Journal of Obstetrics Gynecology and Reproductive Biology, Vol. 183, 01.01.2014, p. 48-51.

Research output: Contribution to journalArticle

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abstract = "Objective To study the association of a multimodal pain protocol (MMPC) and reduced hospital stay after open abdominal hysterectomy. Study design The study design was a comparison of a prospective cohort with a retrospective historical control. We enrolled endometrial cancer patients undergoing open abdominal hysterectomy with lymphadenectomy by the same surgeon. Control patients from 2008 to 2010 who received morphine PCA alone were compared with a similar demographic group of patients from 2011 to 2013 who received MMPC. MMPC consisted of gabapentin (900 mg PO) and acetaminophen (1 g IV) administered 45-60 min preoperatively. The surgical site was injected with bupivacaine with 0.5{\%} epinephrine prior to incision. The postoperative pain control regimen consisted of gabapentin (300 mg PO every 6 h), acetaminophen (1 g IV every 8 h for 24 h postoperatively), ketorolac (15 mg IV every 6 h for 48 h postoperatively), morphine PCA (2 mg IV every 10 min, no basal rate) and oxycodone/acetaminophen (10/325 mg PO every 6 h as needed). Results Length of hospital stay (LOH) of the study cohort (N = 105 with MMPC) was compared with the historical with postoperative morphine alone (N = 113 without MMPC). There were no differences in demographic, uterine cancer stage, or comorbidities between the two arms. The LOH was 1.6 days for patients receiving MMPC and 3.3 days for patients who received morphine alone (P < 0.001). Conclusion Multimodal pain control is associated with significantly reduced hospital stay after open abdominal hysterectomy.",
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