From the Epidemiology group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen (TS, PF) and Department of Anaesthesia, NHS Grampian, Aberdeen, UK (PF).
Eur J Anaesthesiol. 2021 May 1;38(5):505-511. doi: 10.1097/EJA.0000000000001346.
In the United States, postoperative opioid prescriptions have been implicated in the so-called 'opioid epidemic'. In Europe, the extent of overprescribing or misuse of opioids is not known.
To describe the proportion of persistent postoperative opioid use in adults (>18 years) in European countries.
Systematic review of the published data.
We searched the electronic literature databases MEDLINE (Ovid), Embase (Ovid), PubMed/MEDLINE and Scopus.
Studies describing opioid use in adult patients (>18 years) at least 3 months after surgery.
One thousand three hundred and seven studies were found, and 12 studies were included in this review. The rate of opioid use after 3 to 6 months was extracted from the studies and categorised by the type of surgery. Nine studies investigated opioid use after total hip or total knee arthroplasties (THA and TKA) and reported opioid user rates between 7.9 and 41% after 3 months. In all the included studies, a proportion between 2 and 41% of patients were opioid users 3 months after surgery. The level of evidence varied from high to very low.
To describe persistent opioid use in relation to specific countries or types of surgery is not possible. Because of the wide ranges observed, we can neither confirm nor rule out a possible public health problem linked to the persistent use of opioids in Europe.
PROSPERO: CRD42019154292.
在美国，术后开具的阿片类药物处方与所谓的“阿片类药物流行”有关。在欧洲，尚不清楚阿片类药物是否存在过度开具或滥用的情况。
描述欧洲国家成年人（>18 岁）术后持续使用阿片类药物的比例。
对已发表数据的系统评价。
我们检索了电子文献数据库 MEDLINE（Ovid）、Embase（Ovid）、PubMed/MEDLINE 和 Scopus。
描述至少在手术后 3 个月时成年患者（>18 岁）使用阿片类药物的研究。
共发现 1370 项研究，其中 12 项研究纳入本综述。从这些研究中提取术后 3 至 6 个月的阿片类药物使用情况，并按手术类型进行分类。9 项研究调查了全髋关节或全膝关节置换术（THA 和 TKA）后阿片类药物的使用情况，报告术后 3 个月的阿片类药物使用者比例为 7.9%至 41%。在所有纳入的研究中，有 2%至 41%的患者在手术后 3 个月时是阿片类药物使用者。证据水平从高到极低不等。
由于观察到的范围很广，因此无法描述与特定国家或手术类型相关的持续阿片类药物使用情况。我们既不能确认也不能排除欧洲与持续使用阿片类药物相关的潜在公共卫生问题。
PROSPERO：CRD42019154292。
