Opioids and analgesics use after adult spinal deformity surgery correlates with sagittal alignment and preoperative analgesic pattern

European spine journal

article

Anouar Bourghli¹  Louis Boissiere²  Daniel Larrieu²  Farah Kaissar²  Derek Cawley²  Takashi Fujishiro²  David Kieser²  Olivier Gille²  Jean-Marc Vital²  Ahmet Alanay³  Ferran Pellisé⁴  Emre Acaroglu⁵  Francisco-Javier Perez-Grueso⁶  Franck Kleinstück⁵  Ibrahim Obeid² 

[1] Orthopedic and Spinal Surgery Department, Kingdom Hospital;Orthopedic Spinal Surgery Unit 1, Bordeaux Pellegrin Hospital;Spine Surgery Unit, Acibadem Maslak Hospital;Spine Surgery Unit, Hospital Universitario Val Hebron;Ankara Acibadem Spine Center;Spine Surgery Unit, Hospital Universitario La Paz

关键词: Opioids;    NSAID;    Adult spinal deformity;    Health-related quality of life scores;    Sagittal alignment;   

DOI  :  10.1007/s00586-019-06141-8

来源: Springer

【 摘 要 】

To assess pain, health-related quality of life (HRQOL) scores and sagittal parameters of adult spinal deformity (ASD)-operated patients in the context of their analgesic consumption especially opioids (narcotics) over the first year postoperative period. In total, 372 patients from a multicenter database were stratified into 3 groups at baseline: 241 patients in the minimal group (no analgesic, or NSAIDs/narcotics weekly or less), 64 in the NSAIDs every day group and 67 in the narcotics every day group. HRQOL and back and leg pain scores were evaluated at 6 months and 1 year postoperatively. Also several sagittal alignment parameters were assessed. Significant improvements in pain and HRQOL scores were observed across all 3 groups by 1 year (P < 0.05) postoperatively. While the minimal group had the best pre- and postoperative HRQOL scores, the NSAID group demonstrated the best improvement in HRQOL. Only the minimal group displayed continued improvement from 6 months to 1 year. 90%, 65% and 40% of minimal, NSAID and narcotic groups of patients, respectively, no longer took any analgesics at 1 year postoperatively. Alternatively, 36% of patients in the narcotics group continued to take narcotics at 1 year. Residual malalignment increased NSAIDs consumption in different groups at 1 year. This study evaluated the analgesics use after ASD surgery in relation to the clinical and radiological outcomes. Despite important postoperative opioids consumption in the narcotics group, clinical outcome yet improved. Malalignment parameters demonstrated a predictive value in regard to NSAIDs’ usage. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown