{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:53:02Z","timestamp":1784170382737,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research and Education Fund, Department of Anesthesiology, Critical Care and Pain, Hospital for Special Surgery"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: We aimed to investigate the impact of multimodal analgesia on postoperative complications and opioid prescription on a national level. Methods: This retrospective cross-sectional study included n = 1,307,923 hysterectomies (01\/2006\u201312\/2022, Premier Healthcare claims data). Multimodal analgesia was defined as opioid use with the addition of non-opioid analgesic modes, grouped into four categories: opioid-only and 1, 2, or 3 or more additional non-opioid analgesics. Multivariable regression models measured associations between multimodal categories and outcomes (composite\/respiratory\/cardiac\/gastrointestinal\/genitourinary, and CNS complications, oral morphine milligram equivalents [MME], and length of hospital stay [LOS]). Odds ratios (OR) and 95% confidence intervals (CI) are reported. Results: Overall, 84.3% (1,102,812\/1,307,923) received multimodal analgesia, of which 58.9%, 28.0%, and 13.1% received 1, 2, or 3 or more additional non-opioid analgesics, respectively. The odds of any composite complication (any \u22651 complication) decreased with the addition of 1, 2, 3, or more analgesic modalities (versus opioid-only): OR 0.66 (CI 0.64; 0.68), OR 0.63 (CI 0.61; 0.66), OR 0.65 (CI 0.62; 0.67), respectively. Similar patterns existed for respiratory, cardiac, and genitourinary complications. Opioid prescription decreased incrementally with 1,2, 3, or more non-opioid analgesic modalities by 9.51 mg (CI 11.16; 7.86) and 15.29 mg (CI 17.21; 13.37) and 29.35 mg (CI 31.79; 26.91) cumulative MME. LOS was reduced by 0.52 days (CI 0.54; 0.51), 0.49 days (CI 0.51; 0.47), and 0.40 days (CI 0.43; 0.38), respectively. Costs were reduced by $765 (CI 817; 714) or $479 (CI 539; 419) with 1 or 2 multimodal modes. Conclusions: These findings suggest substantial benefits of multimodal analgesia, including significant decreases in serious complications (especially respiratory, cardiac, and genitourinary), opioid consumption, and hospitalizations. Multimodal analgesia may facilitate safe and efficient pain management with optimized opioid consumption.<\/jats:p>","DOI":"10.3390\/jcm13185431","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T04:25:22Z","timestamp":1726201522000},"page":"5431","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Multimodal Analgesia and Outcomes in Hysterectomy Surgery\u2014A Population-Based Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8058-4135","authenticated-orcid":false,"given":"Crispiana","family":"Cozowicz","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah D.","family":"Gerner","sequence":"additional","affiliation":[{"name":"Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyan","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care & Pain Management, Weill Cornell Medical College, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Illescas","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care & Pain Management, Weill Cornell Medical College, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Reisinger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care & Pain Management, Weill Cornell Medical College, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jashvant","family":"Poeran","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care & Pain Management, Weill Cornell Medical College, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiabin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care & Pain Management, Weill Cornell Medical College, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"},{"name":"Department of Anesthesiology, Weill Cornell Medicine, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros G.","family":"Memtsoudis","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020 Salzburg, Austria"},{"name":"Department of Anesthesiology, Critical Care & Pain Management, Weill Cornell Medical College, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA"},{"name":"Department of Anesthesiology, Weill Cornell Medicine, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"611.e1","DOI":"10.1016\/j.ajog.2022.06.028","article-title":"Trends and predictors of hysterectomy prevalence among women in the United States","volume":"227","author":"Harvey","year":"2022","journal-title":"Am. 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