Abstract
OBJECTIVE
To show that zero-opioid discharges after both open and robotic cystectomy are feasible
and to examine the impact of zero-opioid discharges on patient interaction with the
physician's office.
MATERIALS AND METHODS
One hundred seven patients who underwent either open or robotic radical cystectomy
from March 1, 2020 to December 30, 2020 were identified. Patient demographics, perioperative
data, and 30 day pain related outcomes including phone calls, office visits, requests
for pain medication, emergency department visits, and readmissions were abstracted
from the chart. We then examined variables associated with a zero-opioid discharge.
RESULTS
Thirty-two patients were discharged with an opioid prescription (Median Oral Morphine
Equivalents Prescribed = 90) and 75 were discharged without an opioid prescription.
On regression analysis, age (OR 1.07, 95% CI [1.02-1.12]) and pathology (OR 0.36,
95% CI[0.14-0.9]) remained significantly associated with post-operative opioid prescriptions.
There were no differences in the percent of patients presenting to the emergency department,
being readmitted, calling the office, calling the office regarding pain, or requesting
opioid prescriptions within 30 days of discharge, or the number of post-operative
office visits (P >.05 for all).
CONCLUSION
Patients can safely be discharged home without opioids following cystectomy, regardless
of robotic or open approach. Age and pathology are predictors of the need for an opioid
prescription on discharge. These patients did not have increased follow-up visits,
phone calls, or requests for pain medication.
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Article info
Publication history
Published online: August 29, 2022
Accepted:
August 18,
2022
Received:
July 17,
2022
Footnotes
Funding/Disclosures: Bruce Jacobs is supported in part by the Shadyside Hospital Foundation. Dr. Gul is sponsored by the Thomas H. Nimick, Jr. Competitive Research Fund, The Tippins Foundation and The Urology Care Foundation
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
