A new study published in Spine examines preoperative and postoperative opioid use in patients undergoing spine surgery.
There were 583 patients included in the study who self-reported daily opioid use. There is previous work done showing patients with high levels of preoperative opioid use require more intraoperative and immediate postoperative opioid levels. However, opioid prescription remains a standard for back pain patients prior to surgery.
There were around 55 percent of the patients who reported some degree of opioid use, with the average preoperative morphine equivalent being 8.75 mg. Here are five findings from the study.
1. Factors significantly associated with increased intraoperative opioid demand include:
• Younger age
• More invasive surgery
• Anxiety
• Primary surgery
2. The factors associated with increased immediate postoperative opioid demand include:
• Younger age
• Anxiety
• Greater preoperative opioid use
3. The factors associated with decreased opioid independence at 12 months postoperative include:
• More invasive surgery
• Anxiety
• Revision surgery
• Greater preoperative opioid use
4. Psychiatric diagnoses in patients with preoperative opioid use were predictors of the continued opioid use one year after surgery.
5. This study also showed greater preoperative opioid use before undergoing spine surgery increased the immediate postoperative opioid demand as well as decreased postoperative opioid independence. The study authors concluded, "Patients may benefit from preoperative counseling that emphasizes minimizing opioid use prior to undergoing surgery."