Sex Differences in Opioid-Sparing Regimen Prescribing Following Ventral Hernia Repair.

Abstract

<h4>Introduction</h4>While sex differences are known to have a clinically relevant impact on the response to pain therapy, current data are still largely equivocal on sex-specific postoperative pain management. The aim of this study is to determine whether sex predicts differences in pain management in patients undergoing ventral hernia repair (VHR).<h4>Methods</h4>This was a retrospective analysis of prospectively collected data for VHR from the Abdominal Core Health Quality Collaborative. The study population included all opioid-naïve adults, undergoing nonemergent initial management of uncomplicated VHR. Multinominal logistic regression was used to explore if postoperative opioid regimens differed by patient sex.<h4>Results</h4>The final study population included 1325 males (mean age 54 y, 86.7% White, 62.9% open repairs, 75.9% mesh) and 827 females (mean age 51, 75.7% White, 52.5% open repairs, 69.5% mesh). Unadjusted analysis showed that an opioid sparing regimen was offered to 62.27% female patients and 66.34% male patients. Adjusted analysis demonstrated female patients were less likely to receive an opioid-sparing pain regimen when compared to male patients (odds ratio = 0.647, 95% confidence interval: (0.46-0.909), P = 0.012).<h4>Conclusions</h4>Despite having a higher analgesic response than their male counterparts, as well as having a significantly lower morphine consumption postoperatively, female patients were less likely to receive an opioid-sparing regimen. These results show that there is a pressing need to educate clinicians on how sex-specific differences in pain and analgesia may affect opioid prescribing practices. Enhancing clinician awareness about sex-specific differences in pain and analgesia could potentially inform better prescribing practices and promote more equitable postoperative care.