For cervical or lumbar spinal fusion patients, postoperative pain management with opioids is associated with higher postoperative pain scores and decreased quality of life, according to a review presented at the American Society of Anesthesiologists 2018 Annual Meeting in San Francisco, Oct. 13-17.
Researchers assessed nine papers that analyzed opioid use in pain management after spinal fusion. Study authors found:
1. Patients who used opioids preoperatively were six times more likely to use opioids long-term after surgery.
2. The longer patients used opioids preoperatively, the longer they relied on them postoperatively.
3. Preoperative opioid use was associated with a heightened risk of opioid dependence 12 months after the procedure.
4. Preoperative opioid users were more likely to have surgical site pain after fusion.
5. Patients who used opioids preoperative opioid had longer hospital lengths of stay and were more likely to be readmitted after discharge.
"Our review suggests there hasn't been much clinical emphasis on alternative methods to manage pain after back surgery," said Ramneek Dhillon, the study's lead author and University of Toledo (Ohio) College of Medicine and Life Sciences medical student. "While we looked at research on opioid use after spinal surgery, we believe these complications likely occur after other surgeries as well."