Islam Rahib K, Tynes Brynne E, Tong Victoria T, Pelto Anton, Bratton Matthew, Islam Kazi N, Urman Richard D, Ahmadzadeh Shahab, Siddaiah Harish, Rieger Ross, Sterritt Jeffrey, Shekoohi Sahar, Kaye Alan D
School of Medicine, LSU Health Sciences Center New Orleans School of Medicine, 1901 Gravier Street, New Orleans, LA, 70112, USA.
School of Medicine, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, 71103, USA.
Curr Pain Headache Rep. 2025 May 29;29(1):92. doi: 10.1007/s11916-025-01404-0.
This narrative review addresses the growing public health concern of persistent opioid use following major orthopedic surgery. It aims to identify and analyze the critical factors that contribute to the transition from acute to persistent opioid consumption in this context.
Patient-related characteristics, including pre-existing conditions and prior substance use, are critical predictors of prolonged opioid use. Additionally, surgery-related factors such as the type and duration of procedures complicate postoperative pain management. The prevalence of persistent opioid use after surgery remains high despite the emergence of effective Enhanced Recovery After Surgery protocols and patient education initiatives. Multimodal analgesia is highlighted as a vital strategy for reducing the risk of long-term opioid dependency. Persistent opioid use after orthopedic surgery poses significant challenges, including increased risks of physical and mental health complications, the development of opioid use disorder, and a substantial economic burden on healthcare systems. Targeted interventions and continuous research are essential to mitigate these risks, reduce long-term opioid dependency, and improve overall patient outcomes.
本叙述性综述探讨了骨科大手术后持续使用阿片类药物这一日益严重的公共卫生问题。其目的是识别和分析在这种情况下导致从急性阿片类药物使用过渡到持续使用的关键因素。
与患者相关的特征，包括既往疾病和既往药物使用情况，是阿片类药物长期使用的关键预测因素。此外，手术相关因素，如手术类型和持续时间，使术后疼痛管理变得复杂。尽管出现了有效的术后加速康复方案和患者教育举措，但术后持续使用阿片类药物的患病率仍然很高。多模式镇痛被视为降低长期阿片类药物依赖风险的重要策略。骨科手术后持续使用阿片类药物带来了重大挑战，包括身心健康并发症风险增加、阿片类药物使用障碍的发展以及对医疗系统造成巨大经济负担。有针对性的干预措施和持续研究对于降低这些风险、减少长期阿片类药物依赖以及改善患者总体预后至关重要。
