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Use of opioids and other analgesics before and after primary surgery for adult spinal deformity: A 10-year nationwide study

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DOI

  • Frederik Taylor Pitter, Rigshospitalet
  • ,
  • Matt Sikora, Virginia Mason Medical Center
  • ,
  • Martin Lindberg-Larsen, University of Southern Denmark
  • ,
  • Alma Becic Pedersen
  • Benny Dahl, Baylor College of Medicine
  • ,
  • Martin Gehrchen, Rigshospitalet

Objective: To report the 1-year pre and postoperative analgesic use in patients undergoing primary surgery for adult spinal deformity (ASD) and assess risk factors for chronic postoperative opioid use. Methods: Patients > 18 years undergoing primary instrumented surgery for ASD in Denmark between 2006 and 2016 were identified in the Danish National Patient Registry. Infor-mation on analgesic use were obtained from the Danish National Health Service Prescription Database. Use of analgesics was calculated one year before and after surgery for each patient, per quarter (-Q4 to-Q1 before and Q1 to Q4 after). Users were defined as patient with one or more prescriptions in the given quarter. Results: We identified 892 patients. Preoperatively, 28% (n = 246) of patients were opioid users in-Q4 and 33% (n = 295) in-Q1. Postoperatively, 85% (n = 756) of patients were opi-oid users in Q1 and 31% (n = 280) in Q4. Proportions of users of other analgesics (parace-tamol, antidepressants, and anticonvulsants) were stable before and after surgery. Use of nonsteroidal anti-inflammatory drug decreased postoperatively by 40% (-Q1 vs. Q4). 26% of patients had chronic preoperative opioid use (one or more prescriptions in each-Q2 and-Q1) and 24% had chronic postoperative use (prescription each of Q1–Q4). Multivariate logistic regression analysis showed age increment per 10 years and preoperative chronic opioid use as risk factors for chronic postoperative opioid use. Conclusion: One year after ASD surgery, opioid use was not reduced compared to preoperative usage.

Original languageEnglish
JournalNeurospine
Volume17
Issue1
Pages (from-to)237-245
Number of pages9
ISSN2586-6583
DOIs
Publication statusPublished - 2020

    Research areas

  • Adult spinal deformity surgery, Analgesics, Chronic opioid use, Opioids, Pain

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