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Preoperative narcotic use associated with reduced postoperative quality of life

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NEW ORLEANS — Increased narcotic use was associated with worse short-term and long-term outcomes among patients who underwent elective cervical, thoracic or lumbar surgery, according to data presented at the Congress of Neurological Surgeons Annual Meeting.

“It was also associated with longer postoperative visits, but interestingly, there was no association with postop complications and narcotic use,” Scott L. Parker, MD, said, here. 

Parker and colleagues prospectively studied 583 patients. The patients were included in a register with more than half of them reporting using narcotics prior to surgery. They found the cohort improved significantly postoperatively at 3 months and 12 months based on several patient-related outcome measures.

The researchers recorded the amount of narcotics the patients used at the time of surgery and converted that to morphine-equivalent amounts. Then they analyzed the patients’ outcomes to identify whether an independent association existed between narcotic use — low vs. high — and length of hospital stay or complications.

According to Parker, the patients’ demographic were fairly typical.

“Those with worse preoperative outcome scores continued to have worse scores at follow-up,” he said.

Patients who used more narcotics preoperatively had a statistically significantly longer length of postoperative stay (P < .05).

“As such, preoperative narcotic use may help hospitals and providers more appropriately risk stratify patients for surgical selections. And finally, efforts should be made to address narcotic dependence prior to any elective spine surgery to help maximize outcome gains postoperatively,” Parker said.

Since the patients studied underwent various types of surgery, “that would be one limitation to this [study],” he said. – by Susan M. Rapp

Reference:

Parker SL, et al. Paper #127. Presented at: Congress of Neurological Surgeons Annual Meeting; Sept. 26-30, 2015; New Orleans.

Disclosure: Parker reports no relevant financial disclosures.