In-hospital postoperative opioid use and its trends in neurosurgery between 2007 and 2018

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Rautalin , I , Kallio , M & Korja , M 2022 , ' In-hospital postoperative opioid use and its trends in neurosurgery between 2007 and 2018 ' , Acta Neurochirurgica , vol. 164 , no. 1 , pp. 107-116 . https://doi.org/10.1007/s00701-021-05021-9

Title: In-hospital postoperative opioid use and its trends in neurosurgery between 2007 and 2018
Author: Rautalin, Ilari; Kallio, Miia; Korja, Miikka
Contributor organization: Neurokirurgian yksikkö
HUS Neurocenter
HUS Pharmacy
Clinicum
Date: 2022-01
Language: eng
Number of pages: 10
Belongs to series: Acta Neurochirurgica
ISSN: 0001-6268
DOI: https://doi.org/10.1007/s00701-021-05021-9
URI: http://hdl.handle.net/10138/340096
Abstract: Background Postoperative opioid use plays an important role in the global opioid crisis, but little is known about in-hospital opioid use trends of large surgical units. We investigated whether postoperative in-hospital opioid consumption changed in a large academic neurosurgical unit between 2007 and 2018. Methods We extracted the data of consumed opioids in the neurosurgical intensive care unit and two bed wards between 2007 and 2018. Besides overall consumption, we analyzed the trends for weak (tramadol and codeine), strong, and the most commonly used opioids. The use of various opioids was standardized using the defined daily doses (DDDs) of each opioid agent. A linear regression analysis was performed to estimate annual treatment day-adjusted changes with 95% confidence intervals. Results Overall, 121 361 opioid DDDs were consumed during the 196 199 treatment days. Oxycodone was the most commonly used postoperative opioid (49% of all used opioids) in neurosurgery. In the bed wards, the use of oral oxycodone increased 375% (on average 13% (9-17%) per year), and the use of transdermal buprenorphine 930% (on average 26% (9-45%) per year) over the 12-year period. Despite the increased use of strong opioids in the bed wards (on average 3% (1-4%) per year), overall opioid use decreased 39% (on average 6% (4-7%) per year) between 2007 and 2018. Conclusions Due to the increase of strong opioid use in the surgical bed wards, we encourage other large teaching hospitals and surgical units to investigate whether their opioid use trends are similarly worrisome and whether the opioid consumption changes in the hospital setting are transferred to opioid use patterns or opioid-related harms after discharge.
Subject: Analgesics
Opioid
Neurosurgery
Opioid epidemic
UNITED-STATES
PRESCRIPTION
MANAGEMENT
OVERDOSE
DEATHS
CANCER
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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