Surgery patients often go home from the hospital with a prescription for painkillers to take as they recover.
But a new study suggests that doctors should also focus on patients who were taking such medicines before their operations.
People who received prescriptions for opioid painkillers in the months before elective abdominal operations had longer hospital stays, and a higher chance of needing follow-up care in a hospital or rehabilitation facility, than patients who weren’t taking such medications before they had the same operations, the study finds.
The extra care translated into higher costs for their post-surgery care – double or triple the amount, with higher opioid doses associated with higher costs. The results are published in Annals of Surgery by a team from the University of Michigan Institute for Healthcare Policy and Innovation.
The new findings, and past research on the association between opioids and outcomes for other types of surgery, are enough to prompt the researchers to suggest that pre-operation opioid use should be considered a preoperative risk factor.
“We often pause when we are considering elective surgery with a patient, based on known risk factors such as smoking, anticoagulant use, and overall medical conditions. These findings suggest that perhaps preoperative opioid use warrants the same awareness,” says Jennifer Waljee, M.D., M.S., lead author of the study and a plastic surgeon at Michigan Medicine, U-M’s academic medical center.