Association of Intraoperative Opioid Administration With Postoperative Pain and Opioid Use
Authors' conclusion
Contrary to prevailing trends, reduced opioid administration during surgery may have the unintended outcome of increasing postoperative pain and opioid consumption.
Study context
- Population
- Adults undergoing noncardiac surgery with GA at a quaternary care academic centre (Massachusetts General Hospital), April 2016 to March 2020; cesarean, RA, other opioids, ICU admission and intraoperative death excluded
- Participants
- 61,249 adults
- Exposure
- Intraoperative fentanyl vs Intraoperative hydromorphone
- Outcome
- Maximal pain score during PACU stay and cumulative opioid dose (morphine milligram equivalents (MME)) administered during PACU stay
- Follow-up
- PACU stay
Methodological detailspropensity weighted, single-centre
- Propensity weighted
- Single-centre
Main finding
As reported in the abstract
Maximal PACU pain score and PACU opioid administration
- Increased intraoperative fentanyl and hydromorphone both associated with reduced maximum pain scores in postanesthesia care unit (PACU)
- Both exposures associated with reduced probability and reduced total dosage of opioid administration in PACU
- Propensity weighted data set
Observational data: associations, not effects.
Secondary outcomes
Medium- and long-term pain and opioid outcomes (fentanyl)
- Increased fentanyl associated with lower frequency of uncontrolled pain; fewer new chronic pain diagnoses at 3 months; fewer opioid prescriptions at 30, 90 and 180 days; decreased new persistent opioid use
Safety
Adverse effects (fentanyl)
- No significant increases in adverse effects
Original publication
Association of Intraoperative Opioid Administration With Postoperative Pain and Opioid Use. JAMA Surg. Published 1 August 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →