Michelle Verrier1, Shuang Niu1, Kimberly Kroetch2, Karen Buro2, Chris Douglas1, James Green1, Mary E Pedersen3, Derek Dillane4,5. 1. Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada. 2. Department of Mathematics and Statistics, MacEwan University, Edmonton, AB, Canada. 3. Department of Surgery, University of Alberta, Edmonton, AB, Canada. 4. Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada. dillane@ualberta.ca. 5. University of Alberta, 2-150 Clinical Sciences Building, Edmonton, AB, Canada. dillane@ualberta.ca.
Abstract
PURPOSE: The incidence of persistent postsurgical opioid use (PPOU) after complex foot and ankle surgery is unknown. We aimed to determine the incidence and characteristics of PPOU in opioid-naïve, occasional, and regular opioid users at baseline and at six weeks, three months, and six months postoperatively. METHODS: We conducted a prospective observational study in patients undergoing complex foot and ankle surgery over an 18-month period. Daily opioid consumption was recorded at the indicated intervals. Logistic regression models were fit to predict the risk of opioid use at these intervals. The Brief Pain Inventory (BPI) was used to record pain intensity and interference. Correlations were tested between opioid use and BPI interference parameters. RESULTS: Eighty-two out of 139 consecutively approached patients were included in the final analysis. Six percent (98.3% confidence interval [CI], 2 to 20) of patients who were not using opioids preoperatively at baseline were using opioids daily at three and six months after surgery. Fifty percent (98.3% CI, 26 to 73) of patients who were regular opioid users preoperatively continued to use opioids daily six months after surgery. All associations between BPI interference parameters and opioid use were estimated to be positive. CONCLUSION: The probability of using opioid analgesia six months after complex foot and ankle surgery was significantly higher in patients who used opioids preoperatively. Regular preoperative opioid use was associated with a greater risk of PPOU compared with occasional or "as required" opioid use prior to surgery.
PURPOSE: The incidence of persistent postsurgical opioid use (PPOU) after complex foot and ankle surgery is unknown. We aimed to determine the incidence and characteristics of PPOU in opioid-naïve, occasional, and regular opioid users at baseline and at six weeks, three months, and six months postoperatively. METHODS: We conducted a prospective observational study in patients undergoing complex foot and ankle surgery over an 18-month period. Daily opioid consumption was recorded at the indicated intervals. Logistic regression models were fit to predict the risk of opioid use at these intervals. The Brief Pain Inventory (BPI) was used to record pain intensity and interference. Correlations were tested between opioid use and BPI interference parameters. RESULTS: Eighty-two out of 139 consecutively approached patients were included in the final analysis. Six percent (98.3% confidence interval [CI], 2 to 20) of patients who were not using opioids preoperatively at baseline were using opioids daily at three and six months after surgery. Fifty percent (98.3% CI, 26 to 73) of patients who were regular opioid users preoperatively continued to use opioids daily six months after surgery. All associations between BPI interference parameters and opioid use were estimated to be positive. CONCLUSION: The probability of using opioid analgesia six months after complex foot and ankle surgery was significantly higher in patients who used opioids preoperatively. Regular preoperative opioid use was associated with a greater risk of PPOU compared with occasional or "as required" opioid use prior to surgery.
Authors: Oluwadolapo D Lawal; Justin Gold; Amala Murthy; Rupam Ruchi; Egle Bavry; Anne L Hume; Adam K Lewkowitz; Todd Brothers; Xuerong Wen Journal: JAMA Netw Open Date: 2020-06-01
Authors: Karim S Ladha; Mark D Neuman; Gabriella Broms; Jennifer Bethell; Brian T Bateman; Duminda N Wijeysundera; Max Bell; Linn Hallqvist; Tobias Svensson; Craig W Newcomb; Colleen M Brensinger; Lakisha J Gaskins; Hannah Wunsch Journal: JAMA Netw Open Date: 2019-09-04