I was fortunate enough to attend the American Orthopedic Foot and Ankle Society Annual Meeting earlier this month, and many fascinating topics were discussed by healthcare leaders from around the world. One subject that I found interesting was the link between pre-operative opioid use and the connection to poorer post-op outcomes for patients undergoing foot or ankle surgery.
Data on the subject has been limited, but the research we’ve read suggests that patients who take pre-operative opioids have a higher risk for worse outcomes after surgery, which is why we always try to work with patients before surgery to get them to taper off or eliminate their painkiller regimen. New research presented at the AOFAS annual meeting further confirms this link.
Pre-Op Opioid Use
According to research presented by Ryan M. Ridenour, MD, individuals who take opioids prior to their foot or ankle operation are at an increased risk for remaining on an opioid regimen for a longer period once their surgery is complete, and they are more likely to be readmitted for post-op complications.
“We were able to identify preoperative opioid exposure has significant perioperative consequences, which include remaining on narcotics all the way out to 1 year postoperatively, increased risk of readmission at 30 and 90 days postoperatively and is often associated with postoperative complications,” said Dr. Ridenour.
For their study, Ridenour and colleagues identified more than 112,000 patients who underwent foot and ankle surgery and adjusted for comorbidities. When compared to patients who did not take opioids prior to their foot and ankle operation, those who did had a higher risk of:
- Postoperative opioid use
- Readmission
- Deep vein thrombosis
- Pulmonary embolism
- Irrigation and debridement of the surgical site
- Myocardial infarction
- Uninary tract infection
- Postoperative bleeding
Researchers also found that patients who were most likely to be using opioids before their operation were patients who also used tobacco, those with chronic pain and those with some mental health diagnoses. While there’s also the argument that patients with severe injuries are more likely to take medications pre-op, and theses severe injuries may have a lower likelihood of success or a higher likelihood of post-op pain, the full list of problems associated with pre-operative opioid use should raise eyebrows.
If you want help getting ready for foot or ankle surgery, or you simply want to talk to a surgeon who has your best interests in mind, reach out to Dr. Silverman today.