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. 2022 Apr 8;10(4):e4235.
doi: 10.1097/GOX.0000000000004235. eCollection 2022 Apr.

Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria

Steven P Moura  1   2 , Showly Nicholson  1   3 , Yannick Albert J Hoftiezer  3   4   5 , Jonathan Lans  3   4 , Neal C Chen  3   4 , Kyle R Eberlin  1   3
Affiliations

Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria

Steven P Moura et al. Plast Reconstr Surg Glob Open. .

Abstract

Prolonged opioid use after surgery has been a contributing factor to the ongoing opioid epidemic. The purpose of this systematic review is to analyze the definitions of prolonged opioid use in prior literature and propose appropriate criteria to define postoperative prolonged opioid use in hand surgery.

Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines 130 studies were included for review. The primary outcome was the timepoint used to define prolonged opioid use following surgery. The proportion of patients with prolonged use and risk factors for prolonged use were also collected for each study. Included studies were categorized based on their surgical specialty.

Results: The most common timepoint used to define prolonged opioid use was 3 months (n = 86, 67.2% of eligible definitions), ranging from 1 to 24 months. Although 11 of 12 specialties had a mean timepoint between 2.5 and 4.17 months, Spine surgery was the only outlier with a mean of 6.90 months. No correlation was found between the definition's timepoint and the rates of prolonged opioid use.

Conclusions: Although a vast majority of the literature reports similar timepoints to define prolonged postoperative opioid use, these studies often do not account for the type of procedures being performed. We propose that the definitions of postoperative prolonged opioid use should be tailored to the level and duration of pain for specific procedures. We present criteria to define prolonged opioid use in hand surgery.

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Figures

Fig. 1.
Fig. 1.
PRISMA flowchart.
Fig. 2.
Fig. 2.
Mean/median age in included studies.
Fig. 3.
Fig. 3.
Definitions of prolonged opioid use. *N = 150, of which 22 were ineligible for time-based analysis.
Fig. 4.
Fig. 4.
Prolonged opioid use by definition. *N = 122, due to eight studies not reporting a percentage of prolonged opioid use.
Fig. 5.
Fig. 5.
Prolonged opioid use by specialty. *N = 122, due to eight studies not reporting a percentage of prolonged opioid use. Total numbers of studies per speciality are cardiac (3), general (8), gynecologic (4), mixed (21), orthopedic (43), otolaryngology (3), pediatric (1), plastic (3), spine (32), surgical oncology (6), and urologic (6).
Fig. 6.
Fig. 6.
Mean timeframe to define prolonged opioid use by specialty. *N=128, due to 22 definitions not being time-based.
Fig. 7.
Fig. 7.
Risk factors for prolonged opioid use.
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References

    1. US Government Accounting Office. OxyContin abuse and diversion and efforts to address the problem: highlights of a government report. J Pain Palliat Care Pharmacother; 2004;18. - PubMed
    1. Ladha KS, Neuman MD, Broms G, et al. . Opioid prescribing after surgery in the United States, Canada, and Sweden. JAMA Netw Open. 2019;2:e1910734. - PMC - PubMed
    1. Dayer LE, Painter JT, McCain K, et al. . A recent history of opioid use in the US: Three decades of change. Subst Use Misuse. 2019;54:331–339. - PubMed
    1. Thiels CA, Ubl DS, Yost KJ, et al. . Results of a prospective, multicenter initiative aimed at developing opioid-prescribing guidelines after surgery. Ann Surg. 2018;268:457–468. - PubMed
    1. Overton HN, Hanna MN, Bruhn WE, et al. ; Opioids After Surgery Workgroup. Opioid-prescribing guidelines for common surgical procedures: an expert panel consensus. J Am Coll Surg. 2018;227:411–418. - PMC - PubMed