Griffiths Harry, Kent Bridie, Martin Daniel
Peninsula Medical School, University of Plymouth, Plymouth, Devon, UK.
The University of Plymouth Centre for Innovations in Health and Social Care: A JBI Centre of Excellence, University of Plymouth, Plymouth, Devon, UK.
JBI Evid Synth. 2023 Apr 1;21(4):805-811. doi: 10.11124/JBIES-22-00106.
The objective of this review is to determine the incidence of persistent postsurgical use of opioids in adult patients and the associated risk factors.
Surgery has been identified as an independent risk factor for unwarranted chronic opioid use, contributing to opioid-related harm in the community. Persistent opioid use after surgery is associated with morbidity and mortality from opioid-related adverse events, indicating a significant yet mitigable public health concern. There is substantial variation in the reported incidence and risk factors for postoperative opioid use, which require evaluation for future evidence-based risk-reduction strategies.
This review will include studies investigating the persistent use of opioids after 90 postoperative days in adult (≥18 y) patients undergoing surgery of any type, including patients with cancer pain. Selected evidence must report on opioid use prior to surgery. Analytical and descriptive observational studies, and experimental and quasi-experimental studies, published in the previous decade will be eligible for inclusion.
The proposed study methods follow the JBI methodology for systematic reviews of prevalence and incidence. A systematic search will be conducted in PubMed, Embase, CINAHL, Cochrane Central, and Web of Science, and a search of gray literature will include Google Scholar and ClinicalTrials.gov. Study selection, critical appraisal, and data extraction will be performed by 2 independent reviewers aided by the relevant JBI systematic review tools. We aim to produce a narrative synthesis of results and conduct a meta-analysis where feasible, in addition to subgroup analyses of suitable populations. The results are intended to promote safe, evidence-based postoperative opioid prescribing when considering risk factors for persistent postoperative opioid use.
PROSPERO CRD42022320691.
本综述的目的是确定成年患者术后持续使用阿片类药物的发生率及相关危险因素。
手术已被确定为无必要长期使用阿片类药物的独立危险因素，会导致社区中与阿片类药物相关的危害。术后持续使用阿片类药物与阿片类药物相关不良事件的发病率和死亡率有关，这表明这是一个重大但可缓解的公共卫生问题。术后阿片类药物使用的报告发生率和危险因素存在很大差异，需要进行评估以制定未来基于证据的风险降低策略。
本综述将包括对任何类型手术的成年（≥18岁）患者术后90天持续使用阿片类药物的研究，包括癌症疼痛患者。所选证据必须报告术前的阿片类药物使用情况。过去十年发表的分析性和描述性观察性研究以及实验性和半实验性研究均符合纳入条件。
拟采用的研究方法遵循JBI关于患病率和发病率系统评价的方法。将在PubMed、Embase、CINAHL、Cochrane Central和Web of Science中进行系统检索，对灰色文献的检索将包括谷歌学术和ClinicalTrials.gov。研究选择、批判性评价和数据提取将由2名独立评审员借助相关的JBI系统评价工具进行。我们旨在对结果进行叙述性综合，并在可行的情况下进行荟萃分析，此外还将对合适人群进行亚组分析。研究结果旨在在考虑术后持续使用阿片类药物的危险因素时，促进安全、基于证据的术后阿片类药物处方。
PROSPERO CRD42022320691。
