Pain and opioid use after colorectal resection for benign versus malignant disease: A single institution analysis

Studies comparing opioid needs between benign and malignant colorectal diseases are inconclusive. Single institution analysis of prospectively maintained colorectal surgery database. Multiple regression analyses done on perioperative numeric pain scores (NPS) and opioids prescribed at discharge. 641 patients in Benign and 276 patients in the Malignant group. Unadjusted comparison revealed significantly higher NPS for the Benign than the Malignant group preoperative and postoperative day 0 (after surgery), 1, 2, and 3 (all p ​≤ ​0.001). Opioids prescribed at discharge were significantly higher in the Benign group (60.0% vs 51.1%, p ​= ​0.018). After regression analysis, there was no longer a significant difference in NPS (B ​= ​0.703, p ​= ​0.095) and opioids prescribed between groups [OR ​= ​0.803 (95%CI 0.586, 1.1), p ​= ​0.173]. Pain and opioids prescribed at discharge are not significantly different between benign and malignant diseases in an enhanced recovery pain management pathway that maximizes non-opioid multimodal analgesic strategies. [Display omitted] •Pain after colorectal surgery is not higher for benign versus malignant disease.•Opioids prescribed at discharge are not more for benign versus malignant disease.•Enhanced recovery pathways should target other risk variables for opioid needs.