138 Intravenous Morphine Negatively Affects the Length of Hospital Stay in Elective Laparoscopic Major Colorectal Surgery

Aim To identify if Morphine, a strong opioid with undesirable effects on bowel motility, during post-operative recovery from abdominal surgery , adversely affects the length of hospital stay. Method Data was collected retrospectively from patients who underwent elective laparoscopic colorectal surgery over a period of 6 months (July 2022 – December 2022). Results 64 patients were identified, and 4 patients were excluded due to missing data, with a total of 60 patients included in this study. There was no difference in patient characteristics when right-sided and left-sided colonic resections were compared. 15mg of intravenous (IV) morphine delivered by patient-controlled analgesia (PCA) was identified as the median dose in our cohort. The length of hospital stays in those patients who received less than 15mg of IV morphine (50%) had a mean length of stay in the hospital of 5 days (median 4 days; range: 2-15 days) compared to those receiving more than 15mg with a mean length of stay in hospital of 9 days (median 5.5 days; range: 3-43 days; p<0.001). Conclusions Our study reaffirms that increased use of IV morphine has a negative effect on time to opening bowels and a consequent adverse effect on the duration of hospital stay. Hence, alternate analgesia options, strict monitoring, and potential limitation of the total amount of IV morphine prescribed may be beneficial in selected patients undergoing laparoscopic colorectal surgery.