Preoperative opioid use was most commonly reported by patients undergoing orthopedic and neurosurgical spinal procedures, according to results published in JAMA Surgery.
To assess the prevalence of preoperative opioid use, researchers collected preoperative patient and procedural characteristics among 34,186 patients undergoing surgery at a tertiary care academic medical center from March 2010 through April 2016. Overall, 23.1% of patients reported preoperative opioid use.
Results showed hydrocodone bitartrate was the most common opioid used, followed by tramadol hydrochloride and oxycodone hydrochloride. Researchers found preoperative opioid use was independently associated with age of 31 to 40 years, tobacco use, illicit drug use, higher pain severity, depression, higher fibromyalgia survey scores, lower life satisfaction scores and more medical comorbidities. Patients undergoing orthopedic and neurosurgical spinal procedures more commonly reported preoperative opioid use, according to results, while thoracic procedures were least commonly associated with preoperative opioid use.
Researchers noted preoperative opioid use was most likely to be reported by patients undergoing lower extremity procedures, after adjusting for patient characteristics. With patients undergoing intrathoracic surgery as the reference group, results showed patients undergoing pelvic (excluding hip), upper extremity and spinal or spinal cord procedures were also more likely to report preoperative opioid use.
“Current opioid use has significant implications in pain management, and surgeons must be able to identify these patients and establish a safe and effective acute pain management plan that may include preoperative reduction of opioid use, naloxone rescue strategies at discharge and a rational plan of postoperative opioid prescribing,” the authors wrote. – by Casey Tingle
Disclosures: Hilliard reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.