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Chronic Postoperative Opioid Use: A Systematic Review

World Journal of Surgery volume 43, pages 2164–2174 (2019)Cite this article

Abstract

Background

There are a number of studies in the literature that describe the prevalence, causes, and factors associated with chronic postoperative opioid use, but there is a lack of synthesis of the literature to guide clinicians in optimally managing postoperative pain while avoiding opioid dependence. Thus, the goal of this study was to perform a systematic review of the literature to investigate the prevalence of chronic postoperative opioid use and the associated risk factors.

Materials and methods

A systematic search was performed using Ovid Medline and Embase according to PRISMA guidelines. Data were collected on the following outcomes of interest: prevalence of opioid use at 3, 6, and 12 months postoperatively, and risk factors associated with chronic postoperative opioid use.

Results

Forty-three articles were included in the final analysis. The mean prevalence of chronic postoperative opioid use in all populations at 3, 6, and 12 months postoperatively was 30.5%, 25.6%, and 25.2%, respectively. The prevalence of patients who developed chronic opioid use at 3, 6, and 12 months postoperatively was 10.4%, 8.5%, and 9.8%, respectively. Forty of the articles analyzed risk factors associated with chronic postoperative opioid use. The most common associated risk factor identified was preoperative opioid use with 27 articles demonstrating a significant association with chronic postoperative opioid use.

Discussion

The current opioid crisis is in part secondary to the prevalence of chronic opioid use following surgery. This study identified associated risk factors with chronic postoperative opioid use, which may help identify patients at risk for developing chronic postoperative opioid use.

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Affiliations

  1. Section of Otolaryngology - Head and Neck Surgery, Department of Surgery, Cumming School of Medicine, University of Calgary, HRIC 2A02, 3280 Hospital Dr NW, Calgary, AB, T2N 4Z6, Canada

    Ashley Hinther & Joseph C. Dort

  2. Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Omar Abdel-Rahman & Winson Y. Cheung

  3. Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    May Lynn Quan

  4. Ohlson Research Initiative, Arnie Charbonneau Cancer Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Joseph C. Dort

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Hinther, A., Abdel-Rahman, O., Cheung, W.Y. et al. Chronic Postoperative Opioid Use: A Systematic Review. World J Surg 43, 2164–2174 (2019). https://doi.org/10.1007/s00268-019-05016-9

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