University of Kentucky, College of Medicine, Lexington, KY.
University of Kentucky, Division of General Surgery, Lexington, KY.
Surgery. 2020 Nov;168(5):921-925. doi: 10.1016/j.surg.2020.05.048. Epub 2020 Jul 18.
Preoperative opioid use is a risk factor for complications after some surgical procedures. The purpose of this study was to investigate the influence of preoperative opiates on outcomes after ventral hernia repair.
With institutional review board approval, we conducted a retrospective review of consecutive ventral hernia repair cases during a 4-y period.
A striking 48% of the total 234 patients met criteria for preoperative opioid use. Preoperative characteristics and operative details were similar between patient groups (preoperative opioid use versus no preoperative opioid use). Median duration of hospital stay trended toward an increase for opioid users versus nonopioid users (P = .06). Return of bowel function was delayed in opioid users compared with nonopioid users (P = .018). Incidence of superficial surgical site infection was increased among patients who used opioids preoperatively (27% vs 8.3%; P <.001) and remained so after multivariable logistic regression, (adjusted odds ratio 2.9, 95% confidence interval 1.2-6.7; P = .013).
Among patients undergoing ventral hernia repair, those with preoperative opioid use experienced an increased incidence of superficial surgical site infection compared with patients without preoperative opioid use. Further study is needed to understand the relationship between opioid use and surgical site infection after ventral hernia repair.
术前使用阿片类药物是某些手术术后并发症的一个风险因素。本研究的目的是调查术前使用阿片类药物对腹疝修补术后结局的影响。
在获得机构审查委员会批准的情况下,我们对 4 年期间连续进行的腹疝修补病例进行了回顾性研究。
在总共 234 例患者中,有 48%的患者符合术前使用阿片类药物的标准。两组患者的术前特征和手术细节相似(术前使用阿片类药物与未使用术前阿片类药物)。与非阿片类药物使用者相比,阿片类药物使用者的住院时间中位数呈增加趋势(P=.06)。与非阿片类药物使用者相比,阿片类药物使用者的肠功能恢复延迟(P=.018)。与未使用阿片类药物的患者相比,术前使用阿片类药物的患者发生浅表手术部位感染的发生率增加(27%比 8.3%;P<.001),并且在多变量逻辑回归后仍然如此(调整后的优势比 2.9,95%置信区间 1.2-6.7;P=.013)。
在接受腹疝修补术的患者中,与未使用术前阿片类药物的患者相比,术前使用阿片类药物的患者发生浅表手术部位感染的发生率增加。需要进一步研究来了解腹疝修补术后阿片类药物使用与手术部位感染之间的关系。