Preoperative Opioid Prescription Patients Do Not Suffer Distinct Outcomes After Bariatric Surgery: a Matched Analysis of
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ORIGINAL CONTRIBUTIONS
Preoperative Opioid Prescription Patients Do Not Suffer Distinct Outcomes After Bariatric Surgery: a Matched Analysis of Outcomes Nicole Shockcor 1
&
Sakib M. Adnan 1 & Ariel Siegel 1 & Sam Tannouri 1 & Yvonne Rasko 1 & Mark Kligman 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose While over 200 million opioid prescriptions are written annually for chronic pain in the USA, little has been written on the impact of opioids on bariatric surgery, specifically on the effects of prescription opioid use on weight loss post laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). Materials and Methods We completed a matched-cohort, retrospective review in 1176 consecutive patients undergoing primary bariatric surgery at a single institution. Patients were grouped into chronic prescription opioid users (POU), defined as ongoing opioid use for > 3 months at the time of surgery, and opioid-naïve controls (CON), defined as no opioid use prior to surgery. About 130 POU and 130 CON patients were then matched according to preoperative comorbid conditions and demographics. Results Percent total weight loss was similar at 3 weeks, 3 months, 6 months, 1 year, and 2 years in POU and CON—9.6 ± 5.8 vs 8.9 ± 4.5 (p = 0.057), 18.4 ± 7.2 vs 18.5 ± 7.2% (p = 0.901), 28.0 ± 9.4 vs 27.9 ± 12.9% (p = 0.894), 30.3 ± 13.0 vs 32.8 ± 9.0% (p = 0.387), and 31.4 ± 12.7 vs 36.9 ± 21.3% (p = 0.369), respectively. The 30-day readmission, reoperation, venothrombotic event rate, bleeding rate, and infection rate were similar in POU compared to CON patients. Conclusions Complications and weight loss outcomes are similar for prescription opioid users compared to opioid-naïve controls following bariatric surgery. Chronic prescription opioid use is not a contraindication to bariatric surgery. Keywords Bariatric surgery . Opioid . Weight loss . Narcotic use
Introduction Prescription narcotic consumption and abuse in the USA have reached epidemic levels, with nearly 27,000 unintentional drug overdoses in 2007 [1]. Despite increased awareness of the risks for healthcare-related narcotic dependence, opioid prescription practices remain unstandardized, and often excessive, following general surgical and bariatric procedures [2–4]. Surgical patients are routinely prescribed analgesics for postoperative acute pain management, but many patients already regularly use opioids for chronic pain management prior to surgery. This population caries considerable perioperative risk factors
* Nicole Shockcor [email protected] 1
University of Maryland School of Medicine, 29 S. Greene St., Ste 105, Baltimore, MD 21201, USA
and experiences greater morbidity and healthcare utilization following major or minor abdominal surgery [5, 6]. Since the advent of minimally invasive modalities for bariatrics, the popularity of weight loss reduction surgery has increased, with laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) being the most
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