Related Experiment Video
Updated: Jul 23, 2025
06:40
An In Vivo Mouse Model of Total Intravenous Anesthesia During Cancer Resection Surgery
Published on: June 8, 2021
2.5K
Opioid Use in Surgical Management in Musculoskeletal Oncology
Aaron M Gazendam1, Michelle Ghert1, Kenneth R Gundle2
1Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
The Journal of Bone and Joint Surgery. American Volume
|July 19, 2023
Summary
Few musculoskeletal oncology patients develop chronic opioid use after limb-salvage surgery, even with preoperative use. Metastatic bone disease surgery predicts long-term opioid consumption, suggesting tailored prescribing guidelines are needed.
Area of Science:
- Orthopaedic Surgery
- Oncology
- Pain Management
Background:
- Opioid prescribing is a major factor in the opioid epidemic.
- Reducing opioid use in orthopaedic surgery is a priority.
- Musculoskeletal oncology patients have unique needs regarding perioperative opioid use.
Purpose of the Study:
- To describe opioid consumption patterns in musculoskeletal oncology patients undergoing limb-salvage surgery.
- To identify predictors of chronic opioid use in this population.
Main Methods:
- Secondary analysis of the PARITY trial data.
- Included patients undergoing lower-extremity endoprosthetic reconstruction.
- Multivariate logistic regression used to identify predictors of chronic opioid use at 1 year.
Main Results:
- 33.6% of patients used opioids preoperatively.
- Postoperative opioid use decreased significantly over 1 year (6.6% at 1 year).
- Only surgery for metastatic bone disease predicted chronic opioid use (OR 4.90).
Conclusions:
- Chronic opioid use is uncommon in musculoskeletal oncology patients post-surgery.
- Metastatic bone disease is a key predictor of long-term opioid use.
- Specific opioid prescribing guidelines for this patient group are recommended.
More Related Videos
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
338
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
338
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
293
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
293
01:25Analgesia and Pain Management
661
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
661
01:31Skeletal Muscle Relaxants: Therapeutic Uses
517
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
517
01:22Opioid Receptors: Overview
1.1K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
1.1K
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12