Trajectories of pain and opioid use up to one year after surgery: analysis of a European registry.

Hofer, Debora M; Harnik, Michael; Lehmann, Thomas; Stüber, Frank; Baumbach, Philipp; Dreiling, Johannes; Meissner, Winfried; Stamer, Ulrike M (2024). Trajectories of pain and opioid use up to one year after surgery: analysis of a European registry. British journal of anaesthesia, 132(3), pp. 588-598. Elsevier 10.1016/j.bja.2023.12.002

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BACKGROUND

Long-term opioid use after surgery is a crucial healthcare problem in North America. Data from European hospitals are scarce and differentiation of chronic pain has rarely been considered.

METHODS

In a mixed surgical cohort of the PAIN OUT registry, opioid use and chronic pain were evaluated before surgery, and 6 and 12 months after surgery (M6/M12). Subgroups with or without opioid medication and pre-existing chronic pain were analysed. M12-chronic pain was categorised as chronic postsurgical pain (CPSP) meeting the ICD-11 definition, chronic pain related to surgery not meeting the ICD-11 definition, and chronic pain unrelated to surgery. Primary endpoint was the rate of M12 opioid users. Variables associated with M12 opioid use and patient-reported outcomes were evaluated.

RESULTS

Of 2326 patients, 5.5% were preoperative opioid users; 4.4% and 3.5% took opioids at M6 and M12 (P<0.001). Chronic pain before operation and at M6/M12 was reported by 41.2%, 41.8%, and 34.7% of patients, respectively (P<0.001). The rate of M12 opioid users was highest in group unrelated (22.3%; related 8.3%, CPSP 1.5%; P<0.001). New opioid users were 1.1% (unrelated 7.1%, related 2.3%, CPSP 0.7%; P<0.001). M12 opioid users reported more pain, pain-related physical and affective interference, and needed more opioids than non-users. The predominant variable associated with M12 opioids was preoperative opioid use (estimated odds ratio [95% confidence interval]: 28.3 [14.1-56.7], P<0.001).

CONCLUSIONS

Opioid use was low in patients with CPSP, and more problematic in patients with chronic pain unrelated to surgery. A detailed assessment of chronic pain unrelated or related to surgery or CPSP is necessary.

CLINICAL TRIAL REGISTRATION

NCT02083835.

Item Type:

 Journal Article (Original Article)

Division/Institute:

 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Anästhesiologie
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Anästhesiologie
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy > Partial clinic Insel

UniBE Contributor:

 Harnik, Michael, Stüber, Frank, Stamer, Ulrike

Subjects:

 600 Technology > 610 Medicine & health

ISSN:

 1471-6771

Publisher:

 Elsevier

Language:

 English

Submitter:

 Pubmed Import

Date Deposited:

 15 Jan 2024 09:47

Last Modified:

 14 Feb 2024 00:15

Publisher DOI:

 10.1016/j.bja.2023.12.002

PubMed ID:

 38212183

Uncontrolled Keywords:

 ICD-11 chronic postsurgical pain (CPSP) long-term opioid use pain-related interference patient-reported outcomes persistent opioid use postoperative opioids surgery

BORIS DOI:

 10.48350/191558

URI:

 https://boris.unibe.ch/id/eprint/191558

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