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. 2021 Sep;46(9):823-824.
doi: 10.1136/rapm-2020-102462. Epub 2021 Mar 31.

Postoperative opioid consumption after spine surgery: 24 hours or midnight to midnight?

Stephanie Lam  1   2 , Robert Veselis  1   3 , Vivek Malhotra  1   3 , Patrick McCormick  4   3
Affiliations

Postoperative opioid consumption after spine surgery: 24 hours or midnight to midnight?

Stephanie Lam et al. Reg Anesth Pain Med. 2021 Sep.
No abstract available

Keywords: analgesics; chronic pain; methods; opioid; pain; pain measurement; postoperative.

PubMed Disclaimer

Conflict of interest statement

Competing interests: Dr McCormick’s spouse holds stock in Johnson & Johnson.

Figures

Figure 1.
Figure 1.. Illustration of the POD@MN and 24i methods for quantification of postoperative opioid consumption.
POD@MN is calculated starting at anesthesia stop time and ends at 23:59:59 of postoperative day 2. 24i begins at anesthesia stop time and ends 48 hours later. POD = postoperative day.
Figure 2.
Figure 2.. Bland-Altman plot comparing the POD@MN and 24i methods at POD 0 to 1 and 0 to 24 hours post-surgery in opioid tolerant and opioid naïve patients.
Analysis of all cases, which includes opioid tolerant (circle) and opioid naïve (triangle), generated a bias of 43.8 ± 81.9 MME (thick solid black line) and 95% limits of agreement of −117 to 204 MME (dashed black lines). The figure shows an increase in error between POD@MN and 24i as postoperative consumption increased. Spearman rank correlation ρ = 0.63 (P < 0.001). In a perfect correlation, there would be no deviation from y = 0. Although the data in the study was non-parametric, the rationale to use Bland-Altman analysis was two-fold: the lack of a non-parametric alternative to the test and the reduced clinical interpretability with comparing median instead of mean of differences. MME = morphine milligram equivalent; POD@MN = postoperative day beginning at midnight following the date of surgery; 24i = 24-hour intervals after surgery; POD = postoperative day.
See this image and copyright information in PMC

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References

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