Examining Age and Postoperative Opioid Use in the Urogynecology Population: A Prospective Study.

IMPORTANCE: Surgeons must individualize postoperative pain management while also reducing the amount of unused prescribed opioids. OBJECTIVES: This study compared postoperative opioid use in younger versus older women following urogynecologic surgery. We also assessed the likelihood of women returning unused opioids for safe disposal. STUDY DESIGN: This was a prospective study of women undergoing pelvic reconstructive surgery divided into 2 cohorts: younger (<65 years) and older (≥65 years). Our primary outcome was total opioid use, measured in morphine milligram equivalents (MME). We also assessed the average pain score during the first week after surgery measured by a numerical pain scale (range, 0-10). Our secondary outcome was the rate of return of unused prescribed opioids at the 6-week postoperative visit utilizing a disposable drug deactivation system. RESULTS: From April 2019 to September 2021, 152 participants were enrolled: 92 (61%) in the younger cohort (mean age, 51 ± 8 years) and 60 (39%) in the older cohort (mean age, 72 ± 6 years). For our primary outcome, younger women used significantly more opioids during the first postoperative week compared with older women (49 ± 71 vs 28 ± 40 MME, respectively, P = 0.04), despite no difference in average pain scores (4 ± 2 younger vs 3 ± 2 older, P = 0.05). For our secondary outcome, 23% of participants returned their opioids for disposal with the drug deactivation system. CONCLUSIONS: Younger women had higher postoperative opioid use despite similar pain scores after urogynecologic surgery. Among those prescribed opioids, a quarter of participants returned their opioids for disposal at their postoperative visit.

Growth in crisis: A mixed methods study of lessons from our patients with chronic pain during the COVID-19 pandemic

The current COVID-19 global pandemic has disrupted life in many ways. Adapting to a "new normal" continues to be an unsettling experience for many of us. For individuals with chronic pain, adaptation is familiar. In this study we turn to their experience to better understand what resilience can look like in the setting of major life changes. Participants were recruited from an outpatient pain management clinic from mid-March through June 2020 and completed measures assessing resilience, chronic pain acceptance, and an open-ended question examining the impact of chronic pain on their experience during COVID-19. Qualitative and quantitative analyses identified themes of acceptance and resilience. Furthermore, baseline depression was found to be associated with less cognitive/affective positivity (an aspect of resilience) and less pain willingness (an aspect of acceptance). In this brief snapshot of the chronic pain experience, we are reminded of the invaluable lessons learned from our patients. They offer us a model of resilience from which we can foster our own overall wellbeing in the context of continued stress and disruption. (PsycInfo Database Record (c) 2021 APA, all rights reserved)