Sun Mingyang, Chen Wan-Ming, Wu Szu-Yuan, Zhang Jiaqiang
Department of Anesthesiology and Perioperative Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei, Taiwan.
Reg Anesth Pain Med. 2023 May;48(5):205-210. doi: 10.1136/rapm-2022-104144. Epub 2023 Jan 11.
To elucidate the association of presurgical sarcopenia and long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia.
We conducted this population-based propensity score matched to investigate the effects of sarcopenia and long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia between 1 October 2016 and 31 December 2019 from Taiwan's National Health Insurance Research Database. Sarcopenia is a disease and coded as M62.84 in the International Classification of Diseases, 10th Revision, Clinical Modification. The primary outcome was the combined rate of the long-term use of all non-opioid analgesics or opioids over 3 and 6 months after elective surgery. By performing a logistic regression analysis, we calculated the adjusted ORs (aORs) with 95% CIs to identify the independent predictors for long-term non-opioid analgesic and opioid use after surgery.
In total, 2860 patients underwent elective surgery. The 3-month non-opioid analgesic and opioid use rates were respectively 49.7% and 1.8% in the sarcopenia group and 37.9% and 0.9% in the non-sarcopenia group; by contrast, 6-month non-opioid analgesic and opioid use rates were respectively 31.6% and 1.2% in the sarcopenia group and 17.2% and 0.3% in the non-sarcopenia group. Moreover, presurgical sarcopenia increased the risk of long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia (aORs for non-opioid analgesic use over 3 and 6 months after surgery: 1.17 (95% CI 1.05 to 2.23) and 1.26 (95% CI 1.04 to 1.45), respectively; aORs for opioid use over 3 and 6 months after surgery: 1.17 (95% CI 1.07 to 2.21) and 1.23 (95% CI 1.10 to 3.64), respectively).
Sarcopenia is associated with higher rates of long-term non-opioid analgesic and opioid use after elective surgery under general anesthesia.
The aim of this study was to compare the long-term use of non-opioid analgesics and opioids after elective surgery under general anesthesia between patients with and without sarcopenia. Results suggest that patients with sarcopenia are more likely to have increased use of non-opioid analgesics and opioids after surgery. Further research is needed to determine if sarcopenia can be modified prior to surgery and if this impacts the need for long-term pain management with these medications.
阐明术前肌肉减少症与全身麻醉下择期手术后长期非阿片类镇痛药及阿片类药物使用之间的关联。
我们利用台湾国民健康保险研究数据库,进行了这项基于人群的倾向评分匹配研究,以调查2016年10月1日至2019年12月31日期间全身麻醉下择期手术后肌肉减少症以及长期非阿片类镇痛药和阿片类药物使用的影响。肌肉减少症是一种疾病,在《国际疾病分类第10次修订本临床修订版》中编码为M62.84。主要结局是择期手术后3个月和6个月内所有非阿片类镇痛药或阿片类药物长期使用的综合发生率。通过进行逻辑回归分析,我们计算了调整后的比值比(aORs)及95%置信区间(CIs),以确定术后长期非阿片类镇痛药和阿片类药物使用的独立预测因素。
总共2860例患者接受了择期手术。肌肉减少症组3个月的非阿片类镇痛药和阿片类药物使用率分别为49.7%和1.8%,非肌肉减少症组分别为37.9%和0.9%;相比之下,肌肉减少症组6个月的非阿片类镇痛药和阿片类药物使用率分别为31.6%和1.2%,非肌肉减少症组分别为17.2%和0.3%。此外,术前肌肉减少症增加了全身麻醉下择期手术后长期使用非阿片类镇痛药和阿片类药物的风险(术后3个月和6个月非阿片类镇痛药使用的aORs分别为1.17(95%CI 1.05至2.23)和1.26(95%CI 1.04至1.4);术后3个月和6个月阿片类药物使用的aORs分别为1.17(95%CI 1.07至2.)和1.23(95%CI 1.10至3.64))。
肌肉减少症与全身麻醉下择期手术后更高的长期非阿片类镇痛药和阿片类药物使用率相关。
本研究的目的是比较有和没有肌肉减少症的患者在全身麻醉下择期手术后非阿片类镇痛药和阿片类药物的长期使用情况。结果表明,有肌肉减少症的患者术后更有可能增加非阿片类镇痛药和阿片类药物的使用。需要进一步研究以确定术前是否可以改善肌肉减少症,以及这是否会影响这些药物长期疼痛管理的需求。