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New persistent opioid use after bariatric surgery: a systematic review and pooled proportion meta-analysis
Khadija Nasser1, Kevin Verhoeff2,3, Valentin Mocanu4
1Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Surgical Endoscopy
|May 9, 2022
Summary
New, persistent opioid use (NPOU) after bariatric surgery affects 6.0% of patients. Risk factors include prior substance abuse, mental health issues, and peri-operative opioid use. Further research is needed to reduce NPOU.
Area of Science:
- Bariatric Surgery Outcomes
- Opioid Use Disorder
- Post-Surgical Complications
Background:
- Post-surgical new, persistent opioid use (NPOU) is a growing concern.
- Bariatric surgery patients face a heightened risk for NPOU.
- Limited data exists on NPOU rates and associated factors in this population.
Approach:
- Systematic review of multiple databases (MEDLINE, Embase, Scopus, Web of Science, Cochrane) conducted in August 2021.
- Included studies focused on bariatric surgery patients with NPOU defined as opioid use >90 days post-surgery.
- Excluded were abstracts, non-English, animal, small (n<5), and pediatric studies.
Key Points:
- Pooled prevalence of NPOU was 6.0% across four studies.
- Patient factors associated with NPOU: prior substance use, preoperative mental health disorders, and public insurance.
- Surgical factors linked to NPOU: severe post-operative complications and in-hospital opioid use.
Conclusions:
- NPOU is an uncommon yet significant complication after bariatric surgery.
- Identifying high-risk patients (substance abuse, mental health issues) is crucial.
- Further studies are needed to develop strategies for NPOU reduction in bariatric surgery patients.
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