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Area of Science:

  • Anesthesiology
  • Pain Management
  • Public Health

Background:

  • Chronic postoperative opioid use is a growing concern, contributing to the ongoing opioid crisis.
  • Existing literature lacks a synthesized overview to guide clinical management of postoperative pain and opioid dependence.
  • A systematic review is needed to consolidate evidence on prevalence and risk factors.

Purpose of the Study:

  • To systematically review the literature on the prevalence of chronic postoperative opioid use.
  • To identify and analyze risk factors associated with developing chronic opioid dependence after surgery.

Main Methods:

  • A systematic literature search was conducted using Ovid Medline and Embase databases.
  • The search adhered to PRISMA guidelines for systematic reviews.
  • Data extraction focused on prevalence at 3, 6, and 12 months postoperatively and associated risk factors.

Main Results:

  • Analysis included 43 articles, revealing mean chronic postoperative opioid use prevalence of 30.5% at 3 months, 25.6% at 6 months, and 25.2% at 12 months.
  • The incidence of new chronic opioid use postoperatively was 10.4% at 3 months, 8.5% at 6 months, and 9.8% at 12 months.
  • Preoperative opioid use was the most frequently identified risk factor, with 27 studies showing a significant association.

Conclusions:

  • Chronic postoperative opioid use is prevalent and represents a significant contributor to the opioid crisis.
  • Identifying patients at risk through factors like preoperative opioid use is essential for targeted interventions.
  • This review provides critical data to inform clinical practice in managing postoperative pain and mitigating opioid dependence.