Impact of broadly targeted enhanced recovery after surgery protocols in hysterectomy versus other gynecologic surgeries

Introduction

The opioid epidemic in the United States poses a major public health challenge, with postoperative prescribing recognized as a significant source of initial opioid exposure. Midwestern states, including Iowa, have experienced substantial opioid-related morbidity and mortality, reflecting broader national trends of opioid misuse, diversion, and overdose. Excess postoperative opioid prescribing increases the availability of unused medications, which are often retained in households and pose ongoing risks for diversion and nonmedical use. These challenges highlight the need for effective, scalable strategies to reduce opioid exposure at surgical discharge. Accordingly, this study investigated the impact of a broadly targeted Enhanced Recovery After Surgery (ERAS) pathway on opioid prescribing at discharge for hysterectomy patients compared to other gynecologic procedures.