Patients on any of these medications showed an increase in several common complications post-surgery, including infections, prolonged intubation, longer length of stay, readmissions, respiratory failure and even mortality. These problems were particularly pronounced in patients who regularly used opioids prior to surgery.
The preoperative use of opioids, sedatives and antidepressants is on the rise in the U.S. Though the current opioid crisis has raised awareness for limiting opioid use, many patients still receive opioids for pain management, and finding the right balance of medication is an ongoing issue for many patients and doctors. Patients with anxiety disorders or other mental health issues often receive sedatives or antidepressants.
"Most colorectal resections are elective in nature, so we want to focus on the use of opioids and sedatives and counsel patients on the need to decrease the use of these drugs before surgery," Bhakta said. "These drugs are necessary for many patients, but if we can decrease how much they're using, we can help decrease long-term complications. Not only do we want to improve their surgical outcomes, we want to improve their overall health."
Gan et al. A Retrospective Review: Patient-Reported Preoperative Prescription Opioid, Sedative, or Antidepressant Use Is Associated With Worse Outcomes in Colorectal Surgery. Dis Colon Rectum. 2020;63:965-973. doi: 10.1097/DCR.0000000000001655 [Article]