Opioids and Spinal Cord Stimulators: Pre- and Postoperative Opioid Use Patterns and Predictors of Prolonged Postoperative Opioid Use

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dc.contributor.authorLabaran, Lawalen
dc.contributor.authorAryee, Jomar N. A.en
dc.contributor.authorBell, Joshuaen
dc.contributor.authorJain, Nikhilen
dc.contributor.authorPuvanesarajah, Varunen
dc.contributor.authorRaad, Michaelen
dc.contributor.authorJain, Amiten
dc.contributor.authorCarmouche, Jonathan J.en
dc.contributor.authorHassanzadeh, Hamiden
dc.date.accessioned2020-05-13T19:15:11Zen
dc.date.available2020-05-13T19:15:11Zen
dc.date.issued2020-03en
dc.description.abstractObjective: The aim of the study was to compare trends and differences in preoperative and prolonged postoperative opioid use following spinal cord stimulator (SCS) implantation and to determine factors associated with prolonged postoperative opioid use. Methods: A database of private-payer insurance records was queried to identify patients who underwent a primary paddle lead SCS placement via a laminectomy (CPT-C3655) from 2008-2015. Our resulting cohort was stratified into those with prolonged postoperative opioid use, opioid use between 3- and 6-month postoperation, and those without. Multivariate logistic regression was used to determine the effect preoperative opioid use and other factors of interest had on prolonged postoperative opioid use. Subgroup analysis was performed on preoperative opioid users to further quantify the effect of differing magnitudes of preoperative opioid use. Results: A total of 2,374 patients who underwent SCS placement were identified. Of all patients, 1,890 patients (79.6%) were identified as having prolonged narcotic use. Annual rates of preoperative (p = 0.023) and prolonged postoperative narcotic use (p < 0.001) decreased over the study period. Significant independent predictors of prolonged postoperative opioid use were age < 65 years (odds ratio [OR], 1.52; p = 0.004), male sex (OR, 1.33; p = 0.037), preoperative anxiolytic (OR, 1.55; p = 0.004) and muscle relaxant (OR, 1.42; p = 0.033), and narcotic use (OR, 15.04; p < 0.001). Increased number of preoperative narcotic prescriptions correlated with increased odds of prolonged postoperative use. Conclusion: Patients with greater number of preoperative opioid prescriptions may not attain the same benefit from SCSs as patients with less opioid use. The most significant predictor of prolonged narcotic use was preoperative opioid use.en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.14245/ns.1938308.154en
dc.identifier.eissn2586-6591en
dc.identifier.issn2586-6583en
dc.identifier.issue1en
dc.identifier.pmid32252174en
dc.identifier.urihttp://hdl.handle.net/10919/98247en
dc.identifier.volume17en
dc.language.isoenen
dc.rightsCreative Commons Attribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectSpinal cord stimulatoren
dc.subjectChronic painen
dc.subjectSpine surgeryen
dc.subjectOpioidsen
dc.subjectNarcoticsen
dc.titleOpioids and Spinal Cord Stimulators: Pre- and Postoperative Opioid Use Patterns and Predictors of Prolonged Postoperative Opioid Useen
dc.title.serialNeurospineen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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