Chronic pre-operative opioid use and acute pain after fast-track total knee arthroplasty
| Autor: | Torben Hansen, Troels Haxholdt Lunn, Søren Solgaard, Eske Kvanner Aasvang, Henrik Kehlet, Per Wagner Kristensen |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty medicine.medical_treatment Analgesic Total knee arthroplasty 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Humans Medicine Prospective Studies Arthroplasty Replacement Knee Prospective cohort study Pain Postoperative/etiology Acute pain Aged Aged 80 and over Pain Postoperative Analgesics Opioid/adverse effects business.industry Opioid use General Medicine Middle Aged Acute Pain Arthroplasty Pre operative Surgery Analgesics Opioid Anesthesiology and Pain Medicine Area Under Curve Anesthesia Preoperative Period Female Acute Pain/etiology Fast track business 030217 neurology & neurosurgery |
| Zdroj: | Aasvang, E K, Lunn, T H, Hansen, T B, Kristensen, P W, Solgaard, S & Kehlet, H 2016, ' Chronic pre-operative opioid use and acute pain after fast-track total knee arthroplasty ', Acta Anaesthesiologica Scandinavica, vol. 60, no. 4, pp. 529-536 . https://doi.org/10.1111/aas.12667 Aasvang, E K, Lunn, T H, Hansen, T B, Wagner Kristensen, P, Solgaard, S & Kehlet, H 2016, ' Chronic pre-operative opioid use and acute pain after fast-track total knee arthroplasty ', Acta Anaesthesiologica Scandinavica, vol. 60, no. 4, pp. 529-536 . https://doi.org/10.1111/aas.12667 |
| ISSN: | 0001-5172 |
| DOI: | 10.1111/aas.12667 |
| Popis: | Background Pre-operative opioid use has been suggested to increase post-operative pain and opioid consumption after total knee arthroplasty (TKA), but previous studies are either retrospective or inhomogeneous with regard to surgical procedures or control of analgesic regimes, or with few opioid-treated patients, hindering firm conclusions. Methods In a prospective observational study, we investigated the effect of > 4 weeks pre-operative opioid use [none vs. low dose (< 30 mg morphine equivalents (eq.)) vs. high dose (> 30 mg morphine eq.] in patients scheduled for primary, unilateral TKA. All patients had well-defined multimodal opioid-sparring perioperative analgesic therapy, and continued any pre-operative opioid medication. The primary outcome was differences between groups in pain at rest and during walk for the first 6 post-operative days. Results Among 123 patients included, 115 were available for final analysis (93% follow-up rate). Post-operative pain during walk was significantly increased in both opioid-treated groups vs. non-opioid-treated patients (P < 0.009). Secondary analysis of combining all pre-operatively opioid-treated patients vs. opioid-free patients, showed significantly increased pain at rest and walk and increased post-operative opioid requirement - excluding pre-operative dosage - during the first post-operative week in opioid-treated patients (P = 0.001 and P = 0.007, respectively). Conclusion Pre-operative opioid use increases the risk for post-operative pain at rest and walk, and increased opioid consumption after TKA. |
| Databáze: | OpenAIRE |
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