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

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 surg...

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Autores principales: Moura, Steven P., Nicholson, Showly, Hoftiezer, Yannick Albert J., Lans, Jonathan, Chen, Neal C., Eberlin, Kyle R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994078/
https://www.ncbi.nlm.nih.gov/pubmed/35415065
http://dx.doi.org/10.1097/GOX.0000000000004235
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author Moura, Steven P.
Nicholson, Showly
Hoftiezer, Yannick Albert J.
Lans, Jonathan
Chen, Neal C.
Eberlin, Kyle R.
author_facet Moura, Steven P.
Nicholson, Showly
Hoftiezer, Yannick Albert J.
Lans, Jonathan
Chen, Neal C.
Eberlin, Kyle R.
author_sort Moura, Steven P.
collection PubMed
description 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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spelling pubmed-89940782022-04-11 Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria Moura, Steven P. Nicholson, Showly Hoftiezer, Yannick Albert J. Lans, Jonathan Chen, Neal C. Eberlin, Kyle R. Plast Reconstr Surg Glob Open Hand 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. Lippincott Williams & Wilkins 2022-04-08 /pmc/articles/PMC8994078/ /pubmed/35415065 http://dx.doi.org/10.1097/GOX.0000000000004235 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Hand
Moura, Steven P.
Nicholson, Showly
Hoftiezer, Yannick Albert J.
Lans, Jonathan
Chen, Neal C.
Eberlin, Kyle R.
Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria
title Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria
title_full Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria
title_fullStr Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria
title_full_unstemmed Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria
title_short Prolonged Opioid Use following Hand Surgery: A Systematic Review and Proposed Criteria
title_sort prolonged opioid use following hand surgery: a systematic review and proposed criteria
topic Hand
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994078/
https://www.ncbi.nlm.nih.gov/pubmed/35415065
http://dx.doi.org/10.1097/GOX.0000000000004235
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