Photo Credit: Anastasiia Kuznetcova
The following is a summary of “Long-term postoperative opioid use in orthopaedic patients,” published in the December 2023 issue of Pain by Melis et al.
Prior studies using prescription data yielded estimates ranging from 1.4% to 24% for long-term opioid use after orthopedic surgery. Still, limitations in the data obscured the true scope and impact of this issue.
Researchers conducted a prospective study in a high-volume tertiary orthopedic center to determine the prevalence and predictors of long-term opioid use through online patient-reported measures.
They conducted a Dutch cohort study on adult patients who underwent orthopedic surgery (June and August 2021). Six months post-surgery, patients were asked to participate in an online survey regarding current opioid use and their willingness to taper opioids. Demographic information, clinical factors, and pre-operative opioid use were obtained from patient records.
The results showed 607 patients (mean age 61.2 years, 63.4% female). After 6 months, 12.5% (76 patients) used opioids, with 3.3% (20) not using opioids before surgery. The median (Q1–Q3) postoperative daily dose was 29.9 mg (10.0–76.1) morphine equivalents. A majority (88.2%) expressed a desire to taper opioids. Predictors of long-term opioid use included affected body region (ORs: 6.84–12.75) and pre-operative opioid use (OR = 35.33).
Investigators concluded that orthopedic surgery yielded 12.5% of long-term opioid users, highlighting prevention and tapering needs for this vulnerable group.