Prevalence and predictors of opioid use before orthopaedic surgery in an Australian setting: A multicentre, cross-sectional, observational study

Opioid analgesics are commonly used by patients awaiting orthopaedic surgery, and preoperative opioid use is associated with a greater burden of postoperative pain, suboptimal surgical outcomes and higher healthcare costs. This study aimed to examine the prevalence of total opioid use before electiv...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2023-09, Vol.51 (5), p.331-339
Main Authors: Liu, Shania, Stevens, Jennifer A, Collins, Ashleigh E, Duff, Jed, Sutherland, Joanna R, Oddie, Morgan D, Naylor, Justine M, Patanwala, Asad E, Suckling, Benita M, Penm, Jonathan
Format: Article
Language:English
Subjects:
Analgesics
Medical care, Cost of
Narcotics
Observational studies
Opioids
Orthopedic surgery
Orthopedics
Pain
Surgery
Surgical outcomes
Therapeutic use
Treatment
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Summary:Opioid analgesics are commonly used by patients awaiting orthopaedic surgery, and preoperative opioid use is associated with a greater burden of postoperative pain, suboptimal surgical outcomes and higher healthcare costs. This study aimed to examine the prevalence of total opioid use before elective orthopaedic surgery with a focus on regional and rural hospitals in New South Wales, Australia. This was a cross-sectional, observational study of patients undergoing orthopaedic surgery conducted between April 2017 and November 2019 across five hospitals that included a mix of metropolitan, regional, rural, private and public settings. Preoperative patient demographics, pain scores and analgesic use were collected during pre-admission clinic visits, held between two and six weeks before surgery. Of the 430 patients included, 229 (53.3%) were women and the mean age was 67.5 (standard deviation 10.1) years. The overall prevalence of total preoperative opioid use was 37.7% (162/430). Rates of preoperative opioid use ranged from 20.6% (13/63) at a metropolitan hospital to 48.8% (21/43) at an inner regional hospital. Multivariable logistic regression showed that the inner regional setting was a significant predictor of opioid use before orthopaedic surgery (adjusted odds ratio 2.6; 95% confidence interval 1.0 to 6.7) after adjusting for covariates. Opioid use prior to orthopaedic surgery is common and appears to vary by geographical location.
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X221147066