Association of intraop opioid administration with postop pain, opioid use

Editor's Note

This study led by researchers at the Massachusetts General Hospital and Harvard Medical School, Boston, examines the association between intraoperative opioid administration and postoperative pain and opioid use.

A total of 61, 249 surgical patients were included in the analysis.

The researchers found that increased intraoperative:

• fentanyl and hydromorphone administration were associated with reduced pain and opioid administration in the PACU
• fentanyl administration was associated with reduced length of stay and 30-day readmissions, without an increase in adverse effects
• hydromorphone administration was associated with increased length of stay, respiratory depression, and postoperative nausea and vomiting.

It may be necessary to reevaluate opioid-sparing anesthetic regimens because reductions in intraoperative opioid use may have the unintended effect of worsening long-term pain and increasing overall opioid use, the researchers say.