General surgery

The researches find that the women who undergo gynecologic surgery will be prescribed an opioid for the first time, and almost 7% of these women will develop persistent opioid use, new research shows. “Persistent opioid use is common after not only major gynecologic procedures such as hysterectomy; but also after minor procedures such as tubal ligation,” Dr. Jason D. Wright of Columbia University College of Physicians and Surgeons in New York City; the study’s first author, told Reuters Health by email.

Undergoing gynecologic surgery

Dr. Wright and his colleagues looked at Market Scan data on more than 729,000 patients who underwent major or minor gynecologic procedures in 2009-2016. Overall, 60% were prescribe opioids; with rates ranging from 36.7% for dilation and curettage to 79.5% for minimally invasive hysterectomy. Depression, anxiety and substance abuse are each associate with a 3% to 4% increase likelihood of being prescrib opioids; the researchers report in Obstetrics and Gynecology, online.

New persistent opioid use, defined as receiving one or more opioid prescriptions from 90 to 180 days after a procedure, occurred in 6.8% of patients prescribed opioids. Women who underwent dilation and curettage and women who had endometrial ablation had a higher risk of persistent opioid use compared to those who underwent other procedures. But Younger women and Medicaid patients (adjusted risk ratio, 1.79); as well as those living outside the Northeast or with comorbidities, were significantly more likely to develop persistent opioid use.

Patients prescribed opioids

Depression (aRR, 1.14), anxiety (aRR, 1.15) and substance use disorder (aRR, 1.41) were also associated with persistent opioid use. “While it is unclear why these conditions predispose women to persistent opioid use; these findings suggest that opioid should be prescribed judiciously in these populations and extra care should be taken to monitor for persistent opioid use;” Dr. Wright said. “Among women who received an opioid, Medicaid recipients were nearly 80% more likely to have persistent opioid use the women with commercial insurance;” he added.

“While the etiology of the increased risk is uncertain; these findings are in accord with prior studies of other types of surgeries. These data suggest that opioids should be minimized in women with Medicaid to decrease the risk of ongoing use.” development, and training in gynecological surgery. This field is rapidly changing in response to new developments and innovations in endoscopy, robotics, imaging, and other interventional procedures.

The increased risk

Gynecological Surgery is also expanding and now encompasses all surgical interventions pertaining to women’s health, including oncology; urogynecology, and fetal surgery. The journal further provides a forum for education and discussions on broader issues, such as training in minimally invasive surgical technologies. We therefore consider reports and comments on teaching and training programs in surgery with relevance to women’s health.