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Opioid Sparing Anesthesia Decreases In-hospital and One Year Post-Operative Opioid Consumption compared to Traditional Anesthesia: A Propensity-matched Cohort Study – Lumbar Fusion

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The article presents a propensity-matched cohort study that aimed to determine if opioid-sparing anesthesia (OSA) reduces opioid consumption in patients undergoing lumbar spinal fusion surgery. The study found that OSA patients had lower blood loss, surgical time, emergence to extubation time, and recovery room time compared to non-OSA patients. OSA patients also had lower daily opioid consumption from post-operative day 2 and throughout day 4, as well as fewer active opioid prescriptions at 1, 3, 6, and 12 months post-operative. The study concludes that OSA for lumbar spinal fusion surgery can decrease in-hospital and one-year post-operative opioid consumption, potentially leading to shorter recovery times and fewer non-home discharges

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spine clinic in London

Published article

CONCLUSIONS: OSA for lumbar spinal fusion surgery decreases in-hospital and one-year post-operative opioid consumption. The minimal use of opioids may also lead to shorter emergence to extubation times, shorter recovery room stays and fewer discharges to non-home facilities.

Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Spine (Phila Pa 1976). 2023 Aug 23. doi: 10.1097/BRS.0000000000004806. Online ahead of print.ABSTRACTSTUDY DESIGN: Propensity-matched cohort.OBJECTIVE: To determine if opioid-sparing anesthesia (OSA) reduces in-hospital and one-year post-operative opioid consumption.SUMMARY OF BACKGROUND DATA: The recent opioid crisis highlights the need to reduce opioid exposure. We developed an OS) protocol for lumbar spinal fusion surgery to mitigate,

Spine (Phila Pa 1976). 2023 Aug 23. doi: 10.1097/BRS.0000000000004806. Online ahead of print.

ABSTRACT

STUDY DESIGN: Propensity-matched cohort.

OBJECTIVE: To determine if opioid-sparing anesthesia (OSA) reduces in-hospital and one-year post-operative opioid consumption.

SUMMARY OF BACKGROUND DATA: The recent opioid crisis highlights the need to reduce opioid exposure. We developed an OS) protocol for lumbar spinal fusion surgery to mitigate opioid exposure.

METHODS: Patients undergoing lumbar fusion for degenerative conditions over 1 to 4 levels were identified. Patients taking opioids preoperatively were excluded. OSA patients were propensity-matched to non-OSA patients based on age, sex, smoking status, BMI, ASA grade, and revision versus primary procedure. Standard demographic and surgical data, daily in-hospital opioid consumption and opioid prescriptions one year after surgery were compared.

RESULTS: Of 296 OSA patients meeting inclusion criteria, 172 were propensity-matched to Non-OSA patients. Demographics were similar between cohorts (OSA: 77 males, mean age=57.69 y; Non-OSA: 67 males, mean age=58.94 y). OSA patients had lower Blood Loss (326 mL vs. 399 mL, P =0.014), surgical time (201min vs. 233min, P <0.001) emergence to extubation time (9.1min vs. 14.2min, P =<0.001) and recovery room time (119min vs. 140min, P =0.0.012) compared to Non-OSA patients. Fewer OSA patients required non-home discharge (18 vs. 41, P =0.001) compared to the Non-OSA cohort, but no difference in LOS (90.3hrs vs. 98.5hrs, P =0.204). Daily opioid consumption was lower in the OSA versus the Non-OSA cohort from Post-operative Day 2 (223MME vs. 185MME, P =0.017) and maintained each day with lower total consumption (293MME vs. 225MME, P =0.003) throughout Post-operative Day 4. The number of patients with active opioid prescriptions at 1, 3, 6 and 12 months post-operative was statistically fewer in the OSA compared to the Non-OSA patients.

CONCLUSIONS: OSA for lumbar spinal fusion surgery decreases in-hospital and one-year post-operative opioid consumption. The minimal use of opioids may also lead to shorter emergence to extubation times, shorter recovery room stays and fewer discharges to non-home facilities.

PMID:37612894 | DOI:10.1097/BRS.0000000000004806

The London Spine Unit : top spine clinic in London

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Opioid Sparing Anesthesia Decreases In-hospital and One Year Post-Operative Opioid Consumption compared to Traditional Anesthesia: A Propensity-matched Cohort Study

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Spine (Phila Pa 1976). 2023 Aug 23. doi: 10.1097/BRS.0000000000004806. Online ahead of print.ABSTRACTSTUDY DESIGN: Propensity-matched cohort.OBJECTIVE: To determine if opioid-sparing anesthesia (OSA) reduces in-hospital and one-year post-operative opioid consumption.SUMMARY OF BACKGROUND DATA: The recent opioid crisis highlights the need to reduce opioid exposure. We developed an OS) protocol for lumbar spinal fusion surgery to mitigate

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