Pre-op opioid use tied to higher post-op dependence

(HealthDay)—Greater preoperative opioid use predicts increased immediate postoperative opioid demand and decreased incidence of postoperative opioid independence among spine surgery patients, according to a study published in the Dec. 1 issue of Spine.

Sheyan J. Armaghani, M.D., from the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues assessed self-reported daily opioid consumption preoperatively (converted into morphine equivalent amounts) and at the 12-month postoperative point in 583 patients undergoing spine surgery.

The researchers found that the median preoperative morphine equivalent amount for the group was 8.75 mg. More than half of patients (55 percent) reported some degree of opioid use. Increased intraoperative opioid demand was significantly associated with younger age, more invasive surgery, anxiety, and primary surgery (P < 0.05). Similarly, younger age, anxiety, and greater preoperative opioid use were significantly associated with increased immediate postoperative opioid demand (P < 0.05). There was a significant decreased incidence of opioid independence 12 months postoperatively with more invasive surgery, anxiety, revision surgery, and greater preoperative opioid use (P < 0.01).

"Patients may benefit from preoperative counseling that emphasizes minimizing opioid use prior to undergoing spine surgery," the authors write.

Relevant financial activities outside the submitted work were disclosed: consultancy, grants.