Postoperative Opioid Prescribing and Consumption after Hysterectomy: A Prospective Cohort Study

To examine opioid prescribing and consumption patterns after hysterectomy and identify factors associated with postoperative opioid consumption. Prospective cohort study. Single university medical center. Women undergoing hysterectomy for benign, nonobstetric indications. Participant preoperative and surgical characteristics were obtained through chart review and patient report of baseline pain score. During the third postoperative week, participants completed a telephone interview, including a direct count of remaining opioid pills and assessment of satisfaction with pain management. We assessed factors associated with opioid consumption in oral morphine equivalents (OME) using a linear regression model. Of the 129 participants, 113 (88%) completed the postoperative survey after hysterectomy: 16 vaginal, 43 robotic-assisted, 42 conventional laparoscopic, and 12 abdominal hysterectomies. The median amount of opioid prescribed was 150 OME (interquartile range [IQR] 113–200), while the median amount consumed was 75 (IQR 10–135), reflecting an average consumption of about 50% of the prescription. Opioid prescription size was associated with consumption; for every additional oral morphine equivalent prescribed, on average, an additional 0.5 was consumed (p