Lumbar fusion patients taking preop opioids experience worse outcomes — 5 observations

Written by Megan Wood | May 11, 2017 | Print  |

A study examined the preoperative use of opioid analgesics for patients undergoing lumbar fusion, according to Medscape.

Alan T. Villavicencio, MD, of Boulder (Colo.) Neurosurgical Associates, served as first author of the study and presented the findings at the American Association of Neurological Surgeons 2017 Annual Meeting, held April 22 to April 26, in Los Angeles. Journal of Neurosurgery published the study.

 

The study involved 93 patients who underwent one- or two-level transforaminal lumbar interbody fusions for degenerative lumbar conditions. Sixty patients received preoperative opioids with an average dose of 64.4 mg.

 

Here are five observations:

 

1. The groups shared similar demographic and surgical characteristics, but non-opioid users experienced longer average symptom duration.

 

2. The preoperative disability was higher in the opioid group than in the nonuser group, but back and leg pain visual analogue scales and SF-36 Physical Component Summary scores were not statistically different between the two groups preoperatively.

 

3. At 12-month follow-up, the patients who took preoperative opioids experienced higher low back pain in visual analogue scale scores; greater disability and lower health-related SF-36 PCS scores compared to the nonuser patients.

 

4. Dr. Villavicencio commented all patients eventually experienced improvements, whether they took preoperative opioids or not. However, he noted a "statistically significant difference in the amount of improvement based on whether they used opioids preoperatively or not."

 

5. Dr. Villavicencio recommended providers implement a multimodal approach for pain control to reduce opioid use.

 

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