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. 2022 Feb;38(2):137-143.
doi: 10.1055/s-0041-1731640. Epub 2021 Jul 16.

Long-Term Opioid Use Following Surgery for Symptomatic Neuroma

Jonathan Lans  1 , Ritsaart F Westenberg  1 , Rachel E Gottlieb  1 , Ian L Valerio  2 , Neal C Chen  1 , Kyle R Eberlin  2
Affiliations

Long-Term Opioid Use Following Surgery for Symptomatic Neuroma

Jonathan Lans et al. J Reconstr Microsurg. 2022 Feb.

Abstract

Background: Identifying patients at risk for prolonged opioid use following surgery for symptomatic neuroma would be beneficial for perioperative management. The aim of this study is to identify the factors associated with postoperative opioid use of >4 weeks in patients undergoing neuroma surgery.

Methods: After retrospective identification, 77 patients who underwent surgery for symptomatic neuroma of the upper or lower extremity were enrolled. Patients completed the Patient-Reported Outcomes Measurement Information System (PROMIS) depression, Numeric Rating Scale (NRS) pain score, and a custom medication questionnaire at a median of 9.7 years (range: 2.5-16.8 years) following surgery. Neuroma excision followed by nerve implantation (n = 39, 51%), nerve reconstruction/repair (n = 18, 23%), and excision alone (n = 16, 21%) were the most common surgical treatments.

Results: Overall, 27% (n = 21) of patients reported opioid use of more than 4 weeks postoperatively. Twenty-three patients (30%) reported preoperative opioid use of which 11 (48%) did not report opioid use for >4 weeks, postoperatively. In multivariable logistic regression, preoperative opioid use was independently associated with opioid use of >4 weeks, postoperatively (odds ratio [OR] = 4.4, 95% confidence interval [CI]: 1.36-14.3, p = 0.013).

Conclusion: Neuroma surgery reduces opioid use in many patients but patients who are taking opioids preoperatively are at risk for longer opioid use. Almost one-third of patients reported opioid use longer than 4 weeks, postoperatively.

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Conflict of interest statement

N.C.C. reports personal fees from Flexion Medical, Miami Device Solutions, and DePuy Synthes, outside the submitted work. K.R.E. reports personal fees from AxoGen, Integra Lifesciences, and Checkpoint, outside the submitted work. J.L. reports personal fees from AxoGen, outside the submitted work. I.L.V. reports personal fees from AxoGen, Integra Lifesciences, and Stryker Corp., outside the submitted work.

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