Long-Term Postoperative Opioid Use in Orthopedics: Help Wanted

Abstract

Background and Objectives: Opioids are highly effective for treating acute postoperative pain, but evidence of effectiveness in chronic pain is lacking. The recent increase in the number of chronic opioid users in the Netherlands has resulted in a more restrictive prescription policy by perioperative care professionals. Yet, the number of patients with persistent opioid use after orthopedic surgery is currently unknown. This survey was conducted to assess long-term opioid use after orthopedic surgery. Methods: A total of 889 patients were invited to fill in the survey. At six months after orthopedic surgery, patients ≥ 18 years were asked to report pain in the operated area (numeric rating scale, 0-10), painkiller use, and opioid use. If opioid use was reported, the patients were asked whether they wanted to taper or stop these analgesics and whether professional help was desirable. Results: Response rate was 46.7% (n=415). Forty-eight patients (11.6%) were using opioids, of which 41 (85.4%) wanted to taper or stop, and 24 patients preferred professional guidance with this. Opioid users reported significantly higher pain scores in rest and in motion than the patients that used non-opioid painkillers. Conclusions: Almost 12% of the patients continued opioid use six months after orthopedic surgery. A large proportion of these long-term opioid users expressed a desire to stop and requested professional help with this. All healthcare professionals should pay attention to long-term postoperative opioid use of their patients and discuss tapering options with the patient.