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.
Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
World J Surg. 2019 Sep;43(9):2164-2174. doi: 10.1007/s00268-019-05016-9. Epub 2019 May 9.
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.
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.
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.
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.
有许多文献研究描述了慢性术后阿片类药物使用的流行率、原因和相关因素，但缺乏对文献的综合分析，以指导临床医生在优化术后疼痛管理的同时避免阿片类药物依赖。因此，本研究的目的是对文献进行系统回顾，调查慢性术后阿片类药物使用的流行率和相关的风险因素。
根据 PRISMA 指南，使用 Ovid Medline 和 Embase 进行系统搜索。收集了以下感兴趣的结果的数据：术后 3、6 和 12 个月阿片类药物使用的流行率，以及与慢性术后阿片类药物使用相关的风险因素。
最终分析纳入了 43 篇文章。所有人群术后 3、6 和 12 个月慢性术后阿片类药物使用的平均流行率分别为 30.5%、25.6%和 25.2%。术后 3、6 和 12 个月发生慢性阿片类药物使用的患者比例分别为 10.4%、8.5%和 9.8%。40 篇文章分析了与慢性术后阿片类药物使用相关的风险因素。最常见的相关风险因素是术前阿片类药物使用，27 篇文章表明其与慢性术后阿片类药物使用显著相关。
当前的阿片类药物危机部分是由于手术后慢性阿片类药物使用的流行率所致。本研究确定了与慢性术后阿片类药物使用相关的风险因素，这可能有助于识别有发生慢性术后阿片类药物使用风险的患者。
