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| [PMID]: | 28742777 |
| [Au] Autor: | Mueller KG; Memtsoudis SG; Mariano ER; Baker LC; Mackey S; Sun EC |
| [Ad] Endereço: | From *Duke University, Durham, North Carolina; †Department of Anesthesiology, Hospital for Special Surgery, New York, New York; ‡Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, California; §Anesthesiology and Perioperative Care Service, Veterans Affairs, Palo Alto Health Care System, Palo Alto, California; ‖Department of Health Research and Policy, Stanford University School of Medicine, Stanford University, Stanford, California; and ¶National Bureau of Economic Research, Cambridge, Massachusetts. |
| [Ti] Título: | Lack of Association Between the Use of Nerve Blockade and the Risk of Persistent Opioid Use Among Patients Undergoing Shoulder Arthroplasty: Evidence From the Marketscan Database. |
| [So] Source: | Anesth Analg;125(3):1014-1020, 2017 09. | | [Is] ISSN: | 1526-7598 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | BACKGROUND: Persistent opioid use following surgery has received increasing attention from policymakers, researchers, and clinicians. Perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. We examined whether nerve blockade was associated with a decreased risk of persistent opioid use among patients undergoing shoulder arthroplasty, a procedure with high rates of persistent postoperative pain. METHODS: Using health care claims data, we constructed a sample of 6695 patients undergoing shoulder arthroplasty between 2002 and 2012 and used billing data to identify the utilization of nerve blockade. We then used a multivariable logistic regression to estimate the association between nerve blockade and 2 measures of opioid use: having filled at least 1 prescription for an opioid between postoperative days (PODs) 0 and 90, and between POD 91 and 365. This regression adjusted for a variety of potential confounders, such as preoperative opioid use and medical history. RESULTS: There was no association between nerve blockade and our 2 measures of persistent opioid use: adjusted odds ratio, 1.12 (97.5% confidence interval, 0.939-1.34; P = .15) for opioid use between POD 0 and 90, and adjusted odds ratio, 0.997 (97.5% confidence interval, 0.875-1.14; P = .95) for opioid use between POD 91 and 365. CONCLUSIONS: Although the use of perioperative nerve blockade may offer short-term benefits, in this study, it was not associated with a reduction in the risk of persistent opioid use for patients undergoing shoulder arthroplasty. |
| [Mh] Termos MeSH primário: |
Artroplastia do Ombro/tendências
Bases de Dados Factuais/tendências
Bloqueio Nervoso/tendências
Transtornos Relacionados ao Uso de Opioides/prevenção & controle
Dor Pós-Operatória/prevenção & controle
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| [Mh] Termos MeSH secundário: |
Feminino
Seres Humanos
Masculino
Meia-Idade
Transtornos Relacionados ao Uso de Opioides/diagnóstico
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Dor Pós-Operatória/diagnóstico
Dor Pós-Operatória/epidemiologia
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/prevenção & controle
Estudos Retrospectivos
Fatores de Risco
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T |
| [Em] Mês de entrada: | 1709 |
| [Cu] Atualização por classe: | 180108 |
[Lr] Data última revisão:
| 180108 |
| [Sb] Subgrupo de revista: | AIM; IM |
| [Da] Data de entrada para processamento: | 170726 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1213/ANE.0000000000002031 |
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