Predicting Opioid-Dependence Using Pain Intensity And Length Of Pain Suffering In Pre-Spine-Surgery Patients

10.5580/1ea6 ◽  
2007 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Pain Intensity ◽  
Spine Surgery ◽  
Opioid Dependence

Prevalence of opioid dependence in spine surgery patients and correlation with length of stay

2007 ◽  
Vol 3 (3) ◽  
pp. 127 ◽  
Author(s):  
Mohammad Sami Walid, MD, PhD ◽  
Leon Hyer, PhD ◽  
Mohammed Ajjan, MD ◽  
Aaron C. M. Barth ◽  
Joe Sam Robinson, Jr, MD
Keyword(s):  
Regression Analysis ◽  
Length Of Stay ◽  
Pain Intensity ◽  
Spine Surgery ◽  
Opioid Dependence ◽  
Significant Positive Correlation ◽  
Pearson Correlation ◽  
World Health ◽  
Convenience Sample ◽  
Positive Correlation

Objective: We addressed the prevalence of opioid dependence (OD) in spine surgery patients and its correlation with length of stay (LOS) as the most important determinant of hospital cost.Methods: The study took place at Georgia Neurosurgical Institute and the Medical Center of Central Georgia between March 2006 and January 2007. A prospective convenience sample of 150 spine surgery patients (48 lumbar diskectomy, 60 cervical decompression and fusion, and 42 lumbar decompression and fusion [LDF]) was assembled. Patients were interviewed before surgery using a questionnaire designed in accordance with the World Health Organization and DSM-IV-TR criteria for the diagnosis of OD. The prevalence of OD was calculated based on questionnaire results. Pain intensity was quantified during admission using a 0-to-10 pain scale. We used pain intensity multiplied by duration of pain in months (WR index) as a new parameter. Lengths of stay were collected following patients’ discharge from hospital. Pearson correlation and regression analysis were performed using SPSS software.Results: Thirty (20.00 percent) patients were opioid dependent. The prevalence was highest among LDF patients (23.81 percent), females (22.78 percent), and, to a lesser degree, Caucasians (20.87percent). There was no correlation between OD and age (r = 0.08, p > 0.1) or between OD and LOS (r = 0.09, p > 0.1). This study proved a very significant positive correlation between OD and pain intensity (r = 0.24, p < 0.01) and between OD and the WR index (r = 0.30, p < 01). On the other hand, there was a significant positive correlation between LOS and age(r= 0.42, p < 0.01), between LOS and the number of previous spine surgeries (r = 0.28, p < 01), and between LOS and duration of pain (r = 0.18, p < 0.05). Regression analysis showed that age, ethnicity, and type of surgery were the main determinants of LOS.Conclusions: Chronic pain and prolonged use of opioids raise the prevalence of OD in spine surgery patients to 20 percent. The lack of effect of OD on LOS after surgical intervention means that efforts to decrease LOS by trying to satisfy patients’ craving for opioids will not be fruitful. Older, African-American LDF patients with a lengthy history of pain and multiple spine surgeries in the past are the most likely to stay longer in hospital.

Preoperative Norepinephrine Levels in Cerebrospinal Fluid and Plasma Correlate With Pain Intensity After Pediatric Spine Surgery

2017 ◽  
Vol 5 (5) ◽  
pp. 325-333 ◽  
Author(s):  
Catherine E. Ferland ◽  
Alexandre J. Parent ◽  
Neil Saran ◽  
Pablo M. Ingelmo ◽  
Anaïs Lacasse ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Pain Intensity ◽  
Spine Surgery ◽  
Pediatric Spine

Article 3: Fear-Avoidance Beliefs on Pain Intensity and Patient-Reported Disability After Spine Surgery

2009 ◽  
Vol 90 (10) ◽  
pp. e3-e4
Author(s):  
Kristin Archer ◽  
Stephen Wegener ◽  
Caryn Seebach ◽  
Richard Skolasky ◽  
Colleen Thornton ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Spine Surgery ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Patient Reported

scholarly journals Thoracolumbar interfascial plane block for postoperative analgesia in spine surgery: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251980
Author(s):  
Yu Ye ◽  
Yaodan Bi ◽  
Jun Ma ◽  
Bin Liu
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Spine Surgery ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Controlled Trials ◽  
Wound Infiltration ◽  
Rescue Analgesia ◽  
Randomized Controlled ◽  
Analgesia Requirement

Introduction Thoracolumbar interfascial plane (TLIP) block has been discussed widely in spine surgery. The aim of our study is to evaluate analgesic efficacy and safety of TLIP block in spine surgery. Method We performed a quantitative systematic review. Randomized controlled trials that compared TLIP block to non-block care or wound infiltration for patients undergoing spine surgery and took the pain or morphine consumption as a primary or secondary outcome were included. The primary outcome was cumulative opioid consumption during 0-24-hour. Secondary outcomes included postoperative pain intensity, rescue analgesia requirement, and adverse events. Result 9 randomized controlled trials with 539 patients were included for analysis. Compared with non-block care, TLIP block was effective to decrease the opioid consumption (WMD -16.00; 95%CI -19.19, -12.81; p<0.001; I2 = 71.6%) for the first 24 hours after the surgery. TLIP block significantly reduced postoperative pain intensity at rest or movement at various time points compared with non-block care, and reduced rescue analgesia requirement ((RR 0.47; 95%CI 0.30, 0.74; p = 0.001; I2 = 0.0%) and postoperative nausea and vomiting (RR 0.58; 95%CI 0.39, 0.86; p = 0.006; I2 = 25.1%). Besides, TLIP block is superior to wound infiltration in terms of opioid consumption (WMD -17.23, 95%CI -21.62, -12.86; p<0.001; I2 = 63.8%), and the postoperative pain intensity at rest was comparable between TLIP block and wound infiltration. Conclusion TLIP block improved analgesic efficacy in spine surgery compared with non-block care. Furthermore, current literature supported the TLIP block was superior to wound infiltration in terms of opioid consumption.

scholarly journals Magnesium Sulfate Enables Patient Immobilization during Moderate Block and Ameliorates the Pain and Analgesic Requirements in Spine Surgery, Which Can Not Be Achieved with Opioid-Only Protocol: A Randomized Double-Blind Placebo-Controlled Study

2021 ◽  
Vol 10 (19) ◽  
pp. 4289
Author(s):  
Hye-Min Sohn ◽  
Bo-Young Kim ◽  
Yu-Kyung Bae ◽  
Won-Seok Seo ◽  
Young-Tae Jeon
Keyword(s):  
Pain Intensity ◽  
Magnesium Sulfate ◽  
Spine Surgery ◽  
Neuromuscular Blocking ◽  
Controlled Study ◽  
Neurophysiological Monitoring ◽  
Control Group ◽  
Intravenous Anesthesia ◽  
Double Blind ◽  
Analgesic Consumption

Spine surgery is painful despite the balanced techniques including intraoperative and postoperative opioids use. We investigated the effect of intraoperative magnesium sulfate (MgSO4) on acute pain intensity, analgesic consumption and intraoperative neurophysiological monitoring (IOM) during spine surgery. Seventy-two patients were randomly allocated to two groups: the Mg group or the control group. The pain intensity was significantly alleviated in the Mg group at 24 h (3.2 ± 1.7 vs. 4.4 ± 1.8, p = 0.009) and 48 h (3.0 ± 1.2 vs. 3.8 ± 1.6, p = 0.018) after surgery compared to the control group. Total opioid consumption was reduced by 30% in the Mg group during the same period (p = 0.024 and 0.038, respectively). Patients in the Mg group required less additional doses of rocuronium (0 vs. 6 doses, p = 0.025). Adequate IOM recordings were successfully obtained for all patients, and abnormal IOM results denoting warning criteria (amplitude decrement >50%) were similar. Total intravenous anesthesia with MgSO4 combined with opioid-based conventional pain control enables intraoperative patient immobilization without the need for additional neuromuscular blocking drugs and reduces pain intensity and analgesic requirements for 48 h after spine surgery, which is not achieved with only opioid-based protocol.

Intrathecal morphine decreases pain intensity in patients undergoing spine surgery

2006 ◽  
Vol 23 (Supplement 37) ◽  
pp. 113
Author(s):  
M. Werth ◽  
C. Bauer ◽  
B. Mueller ◽  
E. Fritsch ◽  
R. Larsen ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Spine Surgery ◽  
Intrathecal Morphine

scholarly journals Chronic opioid use after spine surgery: what is the prescription for reducing opioid dependence?

2018 ◽  
Vol 4 (4) ◽  
pp. 817-819
Author(s):  
Kamilla Esfahani ◽  
Bhiken I. Naik ◽  
Lauren K. Dunn
Keyword(s):  
Spine Surgery ◽  
Opioid Dependence ◽  
Opioid Use ◽  
Chronic Opioid Use

Interaction of Age and Opioid Dependence on Length of Hospital Stay for Spine Surgery Patients

2009 ◽  
Vol 105 (2) ◽  
pp. 361-364 ◽  
Author(s):  
Leon A. Hyer ◽  
M. Sami Walid ◽  
Andrew M. Brooks ◽  
Dana M. Darmohray ◽  
Joe Sam Robinson
Keyword(s):  
Length Of Stay ◽  
Spine Surgery ◽  
Opioid Dependence ◽  
Length Of Hospital Stay ◽  
Clinical Information ◽  
World Health ◽  
Age Group ◽  
Who Criteria ◽  
Poor Outcomes ◽  
Health Organization

Clinical information suggests that opioid dependence is a major contributor to poor outcomes involving health status and to increased length of stay in hospital settings. Before spine surgery, 150 patients who were using an opioid medication for pain relief were interviewed using the six World Health Organization (WHO) guidelines for the diagnosis of opioid dependence. Three groups were defined: opioid-dependent, nonopioid-dependent, and a subclinical group. Results revealed an average of 20% of patients ( N = 30) who met the WHO criteria for the diagnosis of opioid dependence. There were significant positive correlations between age and number of positive WHO criteria, length of stay, and time under surgery. Length of stay was significantly higher for the older age group (> 55 yr.). ANCOVA analysis using two opioid dependence groups (+ and -) and age group as independent variables affecting length of stay, after controlling for type of surgery, pain intensity, and number of previous spine surgeries, revealed that effects of opioid dependence status and age were significant but their interaction was not. Age did add length of stay independently of opioid dependence status; older adults remain in the hospital longer for various reasons probably associated with comorbidities.

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