American Society for Enhanced Recovery and Perioperative Quality Initiative-4 Joint Consensus Statement on Persistent Postoperative Opioid Use: Definition, Incidence, Risk Factors, and Health Care System Initiatives.

摘要: Persistent postoperative opioid use is thought to contribute the ongoing epidemic in United States. However, efforts study and address issue have been stymied by lack of a standard definition, which has also hampered measure incidence risk factors for persistent use. The objective this systematic review (1) determine clinically relevant definition use, (2) characterize its several common surgeries. Our approach leveraged group international experts from Perioperative Quality Initiative-4, consensus-building conference that included representation anesthesiology, surgery, nursing. A search medical literature yielded 46 articles addressing adults after arthroplasty, abdominopelvic spine thoracic mastectomy, surgery. In opioid-naive patients, overall ranged 2% 6% based on moderate-level evidence. patients who opioids preoperatively had an >30%. Preoperative depression, associated with diagnosis substance disorder, preoperative pain, tobacco were reported factors. addition, while anxiety, sex, psychotropic prescription are these reports lower level While few addressed health policy or prescriber characteristics influence modify behaviors system likely success reducing