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Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
Published on: March 27, 2018
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Chronic opioid use after coronary bypass surgery
Sameer A Hirji1, Samantha Landino1, Claudia Cote1
1Division of Cardiac Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Journal of Cardiac Surgery
|January 10, 2019
Summary
Opioid-exposed patients undergoing coronary artery bypass graft surgery had higher rates of chronic opioid dependence post-surgery compared to opioid-naïve patients. This highlights the impact of prescribing patterns on the opioid epidemic.
Area of Science:
- Cardiology
- Pain Management
- Public Health
Background:
- Opioid dependence is a significant public health crisis.
- Opioid use for surgical pain management may contribute to this epidemic.
- Understanding opioid prescribing patterns is crucial for addressing opioid dependence.
Purpose of the Study:
- To investigate the association between pre-operative opioid exposure and post-operative chronic opioid use after coronary artery bypass graft (CABG) surgery.
- To analyze opioid prescribing patterns in relation to chronic opioid dependence.
Main Methods:
- Retrospective review of isolated CABG patients from 2016.
- Comparison of prescribing patterns and medication usage between opioid-naïve and opioid-exposed patients.
- Definition of chronic opioid dependence as usage beyond 90 days post-discharge.
Main Results:
- Opioid-exposed patients received higher doses of oxycodone and more frequent refills.
- The incidence of chronic opioid dependence was significantly higher in opioid-exposed patients (21.7%) versus opioid-naïve patients (3.2%).
- Relative risk of chronic opioid dependence was 8.5 times higher for opioid-exposed patients.
Conclusions:
- Chronic opioid use 3 months post-CABG affects a substantial portion of opioid-exposed patients.
- Prescribing patterns play a role in the ongoing opioid epidemic.
- There is a critical need for alternative pain management strategies in surgical settings.
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