Pre-Op Opioid Use Tied to Higher Post-Op Dependence

Pre-Op Opioid Use, Higher Post-Op Dependence
Pre-Op Opioid Use, Higher Post-Op Dependence

(HealthDay News) — Greater preoperative opioid use predicts increased immediate postoperative opioid demand and decreased incidence of postoperative opioid independence among spine surgery patients, according to a study published in the December 1 issue of Spine.

Sheyan J. Armaghani, MD, from the Vanderbilt University School of Medicine in Nashville, TN, and colleagues assessed self-reported daily opioid consumption preoperatively (converted into morphine equivalent amounts) and at the 12-month postoperative point in 583 patients undergoing spine surgery.

The researchers found that the median preoperative morphine equivalent amount for the group was 8.75mg. More than half of patients (55%) reported some degree of opioid use. Increased intraoperative opioid demand was significantly associated with younger age, more invasive surgery, anxiety, and primary surgery (P<0.05). Similarly, younger age, anxiety, and greater preoperative opioid use were significantly associated with increased immediate postoperative opioid demand (P<0.05). There was a significant decreased incidence of opioid independence 12 months postoperatively with more invasive surgery, anxiety, revision surgery, and greater preoperative opioid use (P<0.01).

"Patients may benefit from preoperative counseling that emphasizes minimizing opioid use prior to undergoing spine surgery," the authors write.

Relevant financial activities outside the submitted work were disclosed: consultancy, grants.

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