Stefan Wallén1,2, Eva Szabo3,4, Maria Palmetun-Ekbäck5,6, Ingmar Näslund4. 1. School of Health and Medical Sciences, Örebro University, Örebro, Sweden. stefan.wallen@regionorebrolan.se. 2. Pharmacology and Therapeutic Department, Region Örebro County, University Hospital of Örebro, Läkemedelscentrum, Universitetssjukhuset, 701 85, Örebro, Sweden. stefan.wallen@regionorebrolan.se. 3. School of Health and Medical Sciences, Örebro University, Örebro, Sweden. 4. Department of Surgery, University Hospital of Örebro, Örebro, Sweden. 5. Pharmacology and Therapeutic Department, Region Örebro County, University Hospital of Örebro, Läkemedelscentrum, Universitetssjukhuset, 701 85, Örebro, Sweden. 6. Department of Dermatology, University Hospital of Örebro, Örebro, Sweden.
Abstract
BACKGROUND: Little is known regarding the use of opioid analgesics among patients who have undergone bariatric surgery. The Roux-en-Y gastric bypass (RYGB) procedure has been shown to significantly increase the rate of absorption of and exposure to morphine, raising concerns regarding the potentially increased risk of side-effects and the development of substance-use disorder. OBJECTIVES: The aim of this study was to describe the pattern of opioid use over time following RYGB and to see if the pattern differs between patients with a high opioid consumption (HOC) prior to surgery and those with a low consumption (LOC). SETTING: University Hospital of Örebro, Sweden. METHODS: The study was a descriptive retrospective population-based cohort study where two registers with complete coverage were cross-matched. RESULTS: The study population comprised 35,612 persons (1628 HOC, and 33,984 LOC). After surgery, the number of HOC patients increased to 2218. Mean daily opioid consumption in the total population and the LOC group increased after surgery (p < .0005). In the HOC group, there was no difference between mean daily consumption before and after surgery. CONCLUSION: In this nationwide study, we have showed that there is an increase in consumption of opioid analgesics after gastric bypass surgery in Sweden. The increase in the number of individuals with high opioid consumption in the total population was mainly due to an increase in the group of patients with a low consumption prior to surgery.
BACKGROUND: Little is known regarding the use of opioid analgesics among patients who have undergone bariatric surgery. The Roux-en-Y gastric bypass (RYGB) procedure has been shown to significantly increase the rate of absorption of and exposure to morphine, raising concerns regarding the potentially increased risk of side-effects and the development of substance-use disorder. OBJECTIVES: The aim of this study was to describe the pattern of opioid use over time following RYGB and to see if the pattern differs between patients with a high opioid consumption (HOC) prior to surgery and those with a low consumption (LOC). SETTING: University Hospital of Örebro, Sweden. METHODS: The study was a descriptive retrospective population-based cohort study where two registers with complete coverage were cross-matched. RESULTS: The study population comprised 35,612 persons (1628 HOC, and 33,984 LOC). After surgery, the number of HOCpatients increased to 2218. Mean daily opioid consumption in the total population and the LOC group increased after surgery (p < .0005). In the HOC group, there was no difference between mean daily consumption before and after surgery. CONCLUSION: In this nationwide study, we have showed that there is an increase in consumption of opioid analgesics after gastric bypass surgery in Sweden. The increase in the number of individuals with high opioid consumption in the total population was mainly due to an increase in the group of patients with a low consumption prior to surgery.
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