Department of Orthopaedic Surgery, Duke University, Durham, North Carolina.
J Surg Orthop Adv. 2024 Fall;33(3):152-157.
Opioid-limiting legislation has been enacted in response to the opioid epidemic in the United States. However, the impact of this legislation on perioperative opioid prescribing in elective shoulder surgery is not well understood. This is an observational review of 90-day perioperative opioid-prescription filling by patients undergoing shoulder surgery using a national insurance database (n = 231,634 patients) between 2010 and 2019. Statistics evaluated the impact of the year and opioid-limiting legislation on first prescription and cumulative 90-day opioid filling. Initial and cumulative opioid-prescription volume decreased significantly from 2010 to 2019 (49 to 44.4 initial oxycodone 5-mg equivalents, 132.8 to 72.3 cumulative oxycodone 5-mg equivalents; all p < 0.001). States with opioid-limiting legislation had larger reductions in initial and cumulative opioid-prescription filling over similar time frames (p < 0.001). Perioperative opioid prescribing has decreased significantly in shoulder surgery with time and state legislation. Individual prescribers and state and national legislators should continue to seek ways to reduce opioid overprescribing. (Journal of Surgical Orthopaedic Advances 33(3):152-157, 2024).
阿片类药物限制立法是为了应对美国的阿片类药物流行而制定的。然而，这项立法对择期肩部手术围手术期阿片类药物处方的影响尚不清楚。这是一项对使用全国性保险数据库（n=231634 例患者）进行肩部手术的患者在 2010 年至 2019 年期间的 90 天围手术期阿片类药物处方填写情况进行的观察性回顾。统计数据评估了年份和阿片类药物限制立法对首次处方和 90 天内累积阿片类药物使用的影响。从 2010 年到 2019 年，初始和累积阿片类药物处方量显著减少（初始羟考酮 5 毫克当量从 49 减少到 44.4，累积羟考酮 5 毫克当量从 132.8 减少到 72.3；所有 p < 0.001）。在类似的时间框架内，有阿片类药物限制立法的州的初始和累积阿片类药物处方量减少幅度更大（p < 0.001）。随着时间的推移和州立法，肩部手术中的围手术期阿片类药物处方显著减少。个体处方者和州及国家立法者应继续寻求减少阿片类药物过度处方的方法。（《外科矫形进展杂志》33(3):152-157, 2024）。
