TY - JOUR
T1 - Prolonged Opioid Use and Pain Outcome and Associated Factors after Surgery under General Anesthesia
T2 - A Prospective Cohort Association Multicenter Study
AU - Multicenter Perioperative Outcomes Group Enhanced Observation Study Investigator Group for the Multicenter Perioperative Outcomes Group Enhanced Observation Study Collaborator Group
AU - Kuck, Kai
AU - Naik, Bhiken I.
AU - Domino, Karen B.
AU - Posner, Karen L.
AU - Saager, Leif
AU - Stuart, Ami R.
AU - Johnson, Ken B.
AU - Alpert, Salome B.
AU - Durieux, Marcel E.
AU - Sinha, Anik K.
AU - Brummett, Chad M.
AU - Aziz, Michael F.
AU - Cummings, Kenneth C.
AU - Gaudet, John G.
AU - Kurz, Andrea
AU - Rijsdijk, Mienke
AU - Wanderer, Jonathan P.
AU - Pace, Nathan L.
AU - Berman, Mitchell F.
AU - Corradini, Beatriz Raposo
AU - Mincer, Shawn L.
AU - Rose, Sydney E.
AU - Van Klei, Wilton A.
AU - Edwards, David A.
AU - Lamers, Olivia O.A.
AU - Vaughn, Michelle T.
N1 - Publisher Copyright:
Copyright © 2023, the American Society of Anesthesiologists. All Rights Reserved.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background: There is insufficient prospective evidence regarding the relationship between surgical experience and prolonged opioid use and pain. The authors investigated the association of patient characteristics, surgical procedure, and perioperative anesthetic course with postoperative opioid consumption and pain 3 months postsurgery. The authors hypothesized that patient characteristics and intraoperative factors predict opioid consumption and pain 3 months postsurgery. Methods: Eleven U.S. and one European institution enrolled patients scheduled for spine, open thoracic, knee, hip, or abdominal surgery, or mastectomy, in this multicenter, prospective observational study. Preoperative and postoperative data were collected using patient surveys and electronic medical records. Intraoperative data were collected from the Multicenter Perioperative Outcomes Group database. The association between postoperative opioid consumption and surgical site pain at 3 months, elicited from a telephone survey conducted at 3 months postoperatively, and demographics, psychosocial scores, pain scores, pain management, and case characteristics, was analyzed. Results: Between September and October 2017, 3,505 surgical procedures met inclusion criteria. A total of 1,093 cases were included; 413 patients were lost to follow-up, leaving 680 (64%) for outcome analysis. Preoperatively, 135 (20%) patients were taking opioids. Three months postsurgery, 96 (14%) patients were taking opioids, including 23 patients (4%) who had not taken opioids preoperatively. A total of 177 patients (27%) reported surgical site pain, including 45 (13%) patients who had not reported pain preoperatively. The adjusted odds ratio for 3-month opioid use was 18.6 (credible interval, 10.3 to 34.5) for patients who had taken opioids preoperatively. The adjusted odds ratio for 3-month surgical site pain was 2.58 (1.45 to 4.4), 4.1 (1.73 to 8.9), and 2.75 (1.39 to 5.0) for patients who had site pain preoperatively, knee replacement, or spine surgery, respectively. Conclusions: Preoperative opioid use was the strongest predictor of opioid use 3 months postsurgery. None of the other variables showed clinically significant association with opioid use at 3 months after surgery.
AB - Background: There is insufficient prospective evidence regarding the relationship between surgical experience and prolonged opioid use and pain. The authors investigated the association of patient characteristics, surgical procedure, and perioperative anesthetic course with postoperative opioid consumption and pain 3 months postsurgery. The authors hypothesized that patient characteristics and intraoperative factors predict opioid consumption and pain 3 months postsurgery. Methods: Eleven U.S. and one European institution enrolled patients scheduled for spine, open thoracic, knee, hip, or abdominal surgery, or mastectomy, in this multicenter, prospective observational study. Preoperative and postoperative data were collected using patient surveys and electronic medical records. Intraoperative data were collected from the Multicenter Perioperative Outcomes Group database. The association between postoperative opioid consumption and surgical site pain at 3 months, elicited from a telephone survey conducted at 3 months postoperatively, and demographics, psychosocial scores, pain scores, pain management, and case characteristics, was analyzed. Results: Between September and October 2017, 3,505 surgical procedures met inclusion criteria. A total of 1,093 cases were included; 413 patients were lost to follow-up, leaving 680 (64%) for outcome analysis. Preoperatively, 135 (20%) patients were taking opioids. Three months postsurgery, 96 (14%) patients were taking opioids, including 23 patients (4%) who had not taken opioids preoperatively. A total of 177 patients (27%) reported surgical site pain, including 45 (13%) patients who had not reported pain preoperatively. The adjusted odds ratio for 3-month opioid use was 18.6 (credible interval, 10.3 to 34.5) for patients who had taken opioids preoperatively. The adjusted odds ratio for 3-month surgical site pain was 2.58 (1.45 to 4.4), 4.1 (1.73 to 8.9), and 2.75 (1.39 to 5.0) for patients who had site pain preoperatively, knee replacement, or spine surgery, respectively. Conclusions: Preoperative opioid use was the strongest predictor of opioid use 3 months postsurgery. None of the other variables showed clinically significant association with opioid use at 3 months after surgery.
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U2 - 10.1097/ALN.0000000000004510
DO - 10.1097/ALN.0000000000004510
M3 - Article
C2 - 36692360
AN - SCOPUS:85152244444
SN - 0003-3022
VL - 138
SP - 462
EP - 476
JO - Anesthesiology
JF - Anesthesiology
IS - 5
ER -