Design: A randomized controlled trial.

Setting: A tertiary academic medical center.

Patients or Participants: Patients who underwent laparoscopic or robotic hysterectomy for benign indication.

Interventions: Participants undergoing laparoscopic or robotic hysterectomy were randomized into either the non-opioid (NO) arm and received standardized prescriptions for ibuprofen and acetaminophen or the opioid (O) arm in which they also received a prescription for 5 mg oxycodone (12 tablets).

Measurements and Main Results: A total of 70 participants agreed to participate in the study with a randomization ratio of 1:1. Surveys on pain score using an 11-point Likert numeric rating scale and pain control satisfaction were collected on post-operative day 1 (POD1) and post-operative day 7 (POD7). Surveys were completed by 31 participants in the NO arm and 33 participants in the O arm. A total of 8 out of the 31 participants (25.8%) in the NO arm and 3 out of 33 (9.0%) in the O arm requested an additional opioid prescription (p=0.102). The mean numeric pain scores on POD1 and POD7 for the NO and O groups were 4.0 vs 5.0 (p=0.055) and 2.1 vs 3.1 (p=0.061) respectively. The median number of 5mg oxycodone tablets consumed in the O group on POD1 and POD7 were 1 (IQR 0.0, 1.0) and 1 (IQR 0.5, 4.0) respectively. There was no difference in overall pain control satisfaction (90% vs 91% on POD1, p=1.0; 100% vs 100% on POD7, p=1.0) or adverse effects from opioids.

Conclusion: Overall pain score and pain control satisfaction were similar in patients receiving or not receiving an opioid prescription after benign laparoscopic hysterectomy. Three quarters of patients in the non-opioid group did not require any opioids. Overall use was low with a median of 1 tablet of 5 mg oxycodone in the opioid group.