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Post-traumatic Stress Disorder as an Independent Risk Factor for Increased Opioid Use Following Carpal Tunnel Surgery
Nicholas L Hudock1,2, Sean A Kshir1,2, Kenneth F Taylor1,2
1Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
Hand (New York, N.Y.)
|March 24, 2023
Summary
Patients with post-traumatic stress disorder (PTSD) face higher risks of opioid use and emergency department visits after carpal tunnel release surgery. Generalized anxiety disorder (GAD) showed a decreased risk of opioid use.
Area of Science:
- Orthopedic Surgery
- Psychiatry
- Pain Management
Background:
- Carpal tunnel release (CTR) is a common hand surgery with known mental-physical connections.
- Post-traumatic stress disorder (PTSD) and generalized anxiety disorder (GAD) are psychological comorbidities impacting health.
- A literature gap exists regarding PTSD's role in postoperative pain following hand surgery.
Purpose of the Study:
- To investigate the association between PTSD and GAD with postoperative pain after CTR.
- To determine if PTSD or GAD influences the need for opioid analgesia post-surgery.
Main Methods:
- Retrospective analysis of the TriNetX Research Database.
- Identified patients undergoing elective CTR, comparing PTSD and GAD cohorts against controls.
- Matched cohorts and analyzed postoperative opioid usage.
Main Results:
- Patients with PTSD showed a significantly increased risk of postoperative opioid use (P=.033) and higher likelihood of ED visits (P=.001).
- Patients with GAD were significantly less likely to require postoperative opioids (P=.040).
Conclusions:
- PTSD is associated with increased opioid use and ED presentation after CTR.
- GAD is linked to decreased opioid use following CTR.
- Further research into postoperative pain management for PTSD patients is warranted due to unique risks.
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