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Title of the item:

Effect of Preoperative Opioid Dosage on Postoperative Period After Thoracic Spinal Cord Stimulator Surgery.

Title :
Effect of Preoperative Opioid Dosage on Postoperative Period After Thoracic Spinal Cord Stimulator Surgery.
Authors :
Madineni RA; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Smith CM; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Clark SW; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Boorman DW; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Wu C; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Wang D; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Harrop JS; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Sharan AD; Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
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Source :
Pain medicine (Malden, Mass.) [Pain Med] 2018 Apr 01; Vol. 19 (4), pp. 693-698.
Publication Type :
Journal Article
Language :
English
Imprint Name(s) :
Publication: 2016- : Oxford, England : published by Oxford University Press on behalf of the American Academy of Pain Medicine
Original Publication: Malden, MA : Blackwell Science, Inc., c2000-
MeSH Terms :
Length of Stay*
Spinal Cord Stimulation*
Analgesics, Opioid/*therapeutic use
Low Back Pain/*therapy
Adult ; Aged ; Aged, 80 and over ; Analgesia, Patient-Controlled ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies
Substance Nomenclature :
0 (Analgesics, Opioid)
Entry Date(s) :
Date Created: 20171121 Date Completed: 20190401 Latest Revision: 20190401
Update Code :
20210914
DOI :
10.1093/pm/pnx250
PMID :
29155958
Academic Journal
Objective: We aim to study the impact of preoperative opioid dosage on postoperative length of stay (LOS) in patients undergoing thoracic spinal cord stimulator (SCS) placement surgery as a primary objective. Secondary objectives of this study include investigating patient-controlled analgesia (PCA) usage and postoperative complications like fever in relation to patients' preoperative opioid dosage and postoperative LOS.
Methods: A total of 47 patients who underwent thoracic SCS for first time were retrospectively studied through chart review. These patients were categorized into two groups, with Group I patients taking a morphine equivalent dose (MED) of less than 100 mg and Group II patients taking an MED of more than 100 mg preoperatively.
Results: Group I had 22 patients, and Group II had 25 patients. The average age in Group I was 53.45 years, and the average age in Group II was 50.16 years. There were seven males (38%) and 15 females (62%) in Group I, and in Group II there were 11 males (44%) and 14 females (56%). The average LOS in both groups was two days. In Group I, there were 16 patients (73%) who had an LOS of one day and six patients (27%) who had an LOS of more than one day, and in Group II there were 11 patients (44%) who had an LOS of less than one day and 14 patients (56%) who had an LOS of more than one day, with a P value of 0.047. On univariate analysis, postoperative fever and PCA usage correlated with longer hospital stay, with a P value of < 0.001.
Conclusion: Patients on high-dose chronic opioid therapy, defined as an MED greater than 100 mg, who undergo thoracic spinal cord stimulator surgery tend to have longer postoperative hospital stays compared with patients on lower-dose opioid therapy.

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