Impact of methocarbamol on opioid use after ventral incisional hernia repair

Am J Surg. 2023 Dec;226(6):858-863. doi: 10.1016/j.amjsurg.2023.07.007. Epub 2023 Jul 17.

Abstract

Background: Alternatives to opioid analgesia are needed to reduce the risk of abuse, misuse, and diversion. Musculoskeletal pain is a significant contributor to postoperative pain after ventral hernia repair (VHR). We report the impact of methocarbamol on opioid prescribing after VHR.

Methods: Review of all robotic and open VHR, Jan 2020-July 2022. Data was collected in the Abdominal Core Health Quality Collaborative (ACHQC) with additional chart review to assess for opioid refills. A 2:1 propensity score match was performed comparing opioid prescribing in patients prescribed vs not prescribed methocarbamol.

Results: 101 patients received methocarbamol compared with 202 without. Similar number of patients received an opioid prescription (87.1 vs 86.6%; p = 0.904). Study patients received significantly lower MME prescription at discharge (60 v 75; p = 0.021) with no difference in refills (12.5 vs 16.6%; p = 0.386).

Conclusion: Addition of methocarbamol to a multimodal analgesic regimen after VHR facilitates reduction in prescribed opioid with no increase in refills.

Keywords: Methocarbamol; Multimodal analgesia; Opioid; Ventral incisional hernia repair.

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Hernia, Ventral* / surgery
  • Herniorrhaphy
  • Humans
  • Incisional Hernia* / surgery
  • Methocarbamol* / therapeutic use
  • Opioid-Related Disorders* / prevention & control
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / surgery
  • Practice Patterns, Physicians'
  • Retrospective Studies

Substances

  • Analgesics, Opioid
  • Methocarbamol