دورية أكاديمية
أعرض في EDS

Preoperative Predictors of Prolonged Opioid Use in the 6 Months After Total Knee Arthroplasty.

التفاصيل البيبلوغرافية
العنوان: Preoperative Predictors of Prolonged Opioid Use in the 6 Months After Total Knee Arthroplasty.
المؤلفون: Larach DB; Departments of Anesthesiology., Kertai MD; Departments of Anesthesiology., Billings FT 4th; Departments of Anesthesiology., Anderson SB; Departments of Anesthesiology., Polkowski GG; Orthopaedic Surgery., Shinar AA; Orthopaedic Surgery., Milne GL; Medicine, Vanderbilt University Medical Center, Nashville, TN., Mishra P; Departments of Anesthesiology., Bruehl S; Departments of Anesthesiology.
المصدر: The Clinical journal of pain [Clin J Pain] 2023 Oct 01; Vol. 39 (10), pp. 516-523. Date of Electronic Publication: 2023 Oct 01.
نوع المنشور: Observational Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8507389 Publication Model: Electronic Cited Medium: Internet ISSN: 1536-5409 (Electronic) Linking ISSN: 07498047 NLM ISO Abbreviation: Clin J Pain Subsets: MEDLINE
أسماء مطبوعة: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: [New York, N.Y.] : Raven Press, [c1985-
مواضيع طبية MeSH: Arthroplasty, Replacement, Knee*/adverse effects , Opioid-Related Disorders*/epidemiology , Opioid-Related Disorders*/drug therapy , Osteoarthritis, Knee*/surgery , Osteoarthritis, Knee*/drug therapy, Humans ; Analgesics, Opioid/therapeutic use ; Pain, Postoperative/drug therapy ; Pain, Postoperative/psychology ; Anxiety
مستخلص: Objectives: Prolonged postoperative opioid use increases the risk for new postsurgical opioid use disorder. We evaluated preoperative phenotypic factors predicting prolonged postoperative opioid use.
Methods: We performed a secondary analysis of a prospective observational cohort (n=108) undergoing total knee arthroplasty (TKA) for osteoarthritis with 6-week and 6-month follow-up. Current opioid use and psychosocial, pain, and opioid-related characteristics were assessed at preoperative baseline. Primary outcomes were days/week of opioid use at follow-up.
Results: At 6 weeks, preoperative opioid use and greater cumulative opioid exposure, depression, catastrophizing, anxiety, pain interference, sleep disturbance, and central sensitization were significantly associated with more days/week of opioid use after controlling for contemporaneous pain intensity. Prior euphoric response to opioids were also significant predictors at 6 months. All 6-week predictors except anxiety remained significant after controlling for preoperative opioid use; at 6 months, cumulative opioid exposure, catastrophizing, pain interference, and sleep disturbance remained significant after this adjustment ( P <0.05). In multivariable models, a psychosocial factor reflecting negative affect, sleep, and pain accurately predicted 6-week opioid use (area under the curve=0.84). A combined model incorporating psychosocial factor scores, opioid-related factor scores, and preoperative opioid use showed near-perfect predictive accuracy at 6 months (area under the curve=0.97).
Discussion: Overall, preoperative psychosocial, pain-related, and opioid-related phenotypic characteristics predicted prolonged opioid use after total knee arthroplasty.
Competing Interests: This work was supported by the National Institute on Aging, Gaithersburg, MD (R01AG048915, P30AG024968), the National Institute on Drug Abuse, Rockville, MD (R01DA050334, K23DA057387), the National Institute of General Medical Sciences, Bethesda, MD (R01GM112871, T32GM108554), and the National Center for Advancing Translational Sciences. Bethesda, MD (UL1TR000445). The authors declare no conflict of interest.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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معلومات مُعتمدة: UL1 TR000445 United States TR NCATS NIH HHS; R01 DA050334 United States DA NIDA NIH HHS; K23 DA057387 United States DA NIDA NIH HHS; R01 AG048915 United States AG NIA NIH HHS; P30 AG024968 United States AG NIA NIH HHS; R01 GM112871 United States GM NIGMS NIH HHS; T32 GM108554 United States GM NIGMS NIH HHS
المشرفين على المادة: 0 (Analgesics, Opioid)
تواريخ الأحداث: Date Created: 20230713 Date Completed: 20230914 Latest Revision: 20231003
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10529895
DOI: 10.1097/AJP.0000000000001143
PMID: 37440337
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-5409
DOI:10.1097/AJP.0000000000001143