Long-term analgesic and opioid prescription after surgery under general or neuraxial anesthesia: A retrospective nationwide sampling study

doi:10.1016/j.jclinane.2021.110438

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Title:	Long-term analgesic and opioid prescription after surgery under general or neuraxial anesthesia: A retrospective nationwide sampling study
Authors:	Yu, Chia-Hung Chen, Yi-Chen Hung, I-Yin Chen, Jen-Yin Chang, Ying-Jen Ho, Chung-Han Chu, Chin-Chen
Contributors:	Chi Mei Med Ctr, Dept Anesthesiol Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Pharm Chia Nan Univ Pharm & Sci, Dept Recreat & Hlth Care Management
Keywords:	Surgery General anesthesia Neuraxial anesthesia Long-term analgesic prescription Opioids
Date:	2021
Issue Date:	2023-11-11 11:48:57 (UTC+8)
Publisher:	ELSEVIER SCIENCE INC
Abstract:	Study objective: Chronic postsurgical pain (CPSP) is a common and underreported but significant outcome following surgery. Pharmacological treatment with analgesics, including non-opioids and opioids, is frequently used. It has been debated whether neuraxial anesthesia can reduce persistent analgesic use. We aimed to survey long-term analgesic prescription after different surgeries under general and neuraxial anesthesia, using a nationwide database. Design: Retrospective case-control study. Setting: This study used data corresponding to the period from 2000 to 2016 from a longitudinal generation tracking database, which includes the claims data of 2 million randomly selected beneficiaries in Taiwan. Patients: Patients (n = 110,654) who underwent herniorrhaphy, hip/knee replacement, and lower-limb open reduction internal fixation (ORIF) or amputation were enrolled. Interventions: We categorized patients into general or neuraxial anesthesia groups, compared the rates of long-term analgesic prescription between the two groups, and estimated the adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) using multivariable logistic regression analysis. Main results: Lower rates of long-term analgesic prescription were noted in patients who underwent herniorrhaphy (3 months post-surgery: aOR, 0.88; 95% CI, 0.84-0.93; 6 months post-surgery: aOR, 0.90; 95% CI, 0.84-0.96), hip replacement (3 months post-surgery: aOR, 0.91; 95% CI, 0.85-0.97), and lower-limb ORIF (3 months post-surgery: aOR, 0.91; 95% CI, 0.88-0.94; 6 months post-surgery: aOR, 0.95; 95% CI, 0.92-0.99) under neuraxial anesthesia than under general anesthesia. Lesser long-term opioid prescription after herniorrhaphy (3 months post-surgery: aOR, 0.52; 95% CI, 0.36-0.75; 6 months post-surgery: aOR, 0.58; 95% CI, 0.42-0.81) and lower-limb ORIF (3 months post-surgery: aOR, 0.55; 95% CI, 0.47-0.65; 6 months post-surgery: aOR, 0.67; 95% CI, 0.56-0.80) was observed under neuraxial anesthesia than under general anesthesia. Conclusions: Neuraxial anesthesia may be associated with lower rates of long-term analgesic and opioid prescription after some surgeries, especially herniorrhaphy and lower-limb ORIF.
Relation:	J CLIN ANESTH, v.75
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles [Dept. of Recreation and Health-Care Management] Periodical Articles

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