Department of Surgery, Michigan Medicine, Ann Arbor, MI.
Michigan Opioid Prescribing and Engagement Network, Ann Arbor, MI.
Ann Surg. 2022 Nov 1;276(5):e577-e583. doi: 10.1097/SLA.0000000000004560. Epub 2020 Oct 15.
To describe the incidence of new persistent opioid use after inguinal hernia repair as well as its associated risk factors.
The development of new persistent opioid use after surgery is a common complication; however, its incidence following inguinal hernia repair has not been described. Given that roughly 800,000 inguinal hernia repairs are performed annually in the USA, any incidence could have profound implications for patients.
A retrospective cross-sectional study of the incidence of new persistent opioid use after inguinal hernia repair using a national database of de-identified administrative health claims of opioid-naïve patients undergoing surgery from 2008 to 2016.
During the study period, 59,795 opioid-naïve patients underwent inguinal hernia repair and met inclusion criteria. Mean (SD) age was 57.8 (16.1) years and 55,014 (92%) patients were male. Nine hundred twenty-two (1.5%) patients continued filling opioids prescriptions for at least 3 months after surgery. The most significant risk factor for developing new persistent opioid use after surgery was filling an opioid prescription in the 30 days before surgery (odds ratio 4.34, 95% confidence interval 3.75-5.01). These prescriptions were provided by surgeons in 52% of cases and primary care physicians in 16% of cases. Other risk factors for new persistent opioid use included receiving a larger opioid prescription, having more comorbidities, having a major postoperative complication, and certain mental health disorders and pain disorders.
After undergoing inguinal hernia repair, 1.5% of patients developed new persistent opioid use. Filling an opioid prescription in the 30 days before surgery had the strongest association with this complication.
描述腹股沟疝修补术后新的持续性阿片类药物使用的发生率及其相关的危险因素。
手术后新的持续性阿片类药物使用的发展是一种常见的并发症；然而，其在腹股沟疝修补术后的发生率尚未被描述。由于每年在美国大约有 800,000 例腹股沟疝修补术，任何发生率都可能对患者产生深远的影响。
使用 2008 年至 2016 年期间接受手术的阿片类药物-naive 患者的全国性匿名行政健康索赔数据库，进行一项回顾性横断面研究，以确定腹股沟疝修补术后新的持续性阿片类药物使用的发生率。
在研究期间，59795 例阿片类药物-naive 患者接受了腹股沟疝修补术并符合纳入标准。平均（SD）年龄为 57.8（16.1）岁，55014 例（92%）患者为男性。922 例（1.5%）患者在手术后至少 3 个月继续服用阿片类药物处方。手术后发生新的持续性阿片类药物使用的最显著危险因素是在手术前 30 天内填写阿片类药物处方（优势比 4.34，95%置信区间 3.75-5.01）。这些处方中有 52%是由外科医生开具的，16%是由初级保健医生开具的。新的持续性阿片类药物使用的其他危险因素包括接受较大剂量的阿片类药物处方、有更多的合并症、有重大术后并发症以及某些精神健康障碍和疼痛障碍。
在接受腹股沟疝修补术后，1.5%的患者出现新的持续性阿片类药物使用。在手术前 30 天内开具阿片类药物处方与该并发症的相关性最强。
