Preoperative long-acting opioid use was found to be associated with longer lengths of hospital stay and increased all-cause and pain-related readmission in patients undergoing inpatient and ambulatory surgeries, respectively, according to a study published in Pain Medicine.

The study included participants who underwent elective noncardiac surgeries, with inpatient and ambulatory surgeries in separate cohorts. Postoperative outcomes were examined in patients administered long-acting opioids and in opioid-naive participants. Opioid use was determined using preoperative medication lists, and the effect of long-acting opioid use on readmission rate, respiratory failure, and adverse cardiac events was assessed with multivariable regression analysis. Of 93,644 participants, 23,605 underwent inpatient surgeries (22,365 of whom were opioid-naive) and 70,039 underwent ambulatory surgeries (69,257 of whom were opioid-naive).

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For inpatient surgeries, preoperative long-acting opioid use was associated with an increased risk for prolonged length of stay (incidence rate ratio [IRR], 1.1; 99% CI, 1.0-1.2; P <.01), but not with readmission. For ambulatory surgeries, perioperative long-acting opioid use was associated with increased risk for both all-cause readmission (odds ratio [OR], 2.1; 99% CI, 1.5-2.9, P <.001) and pain-related readmission (OR, 2.0; 99% CI, 0.85-4.2; P =.02). No associations were established between perioperative long-acting opioid use and respiratory failure or adverse cardiac events.

“Though the total number of long-acting opioid prescriptions in the United States has decreased over time, for those who are prescribed long-acting opioids, future studies on interventions that may improve surgical outcome are needed,” the researchers noted.

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Reference

Doan LV, Wang J, Padjen K, et al. Preoperative long-acting opioid use is associated with increased length of stay and readmission rates after elective surgeries [published online February 25, 2019]. Pain Med. doi:10.1093/pm/pny318