For a study, researchers sought to assess the risks of early and protracted post-operative opioid usage in patients receiving nephrectomy by minimally invasive surgery (MIS) versus open surgery.
Prescriptions established post-discharge opioid use in the Ontario Drug Benefit database (age ≥65 years) and the Narcotics Monitoring System for opioid-naive patients in Ontario who underwent nephrectomy for kidney cancer (1994-2017, n = 7,900). (all patients from 2012). For ≥1 prescription 1-90 days after surgery was considered early opioid usage. Two distinct definitions of chronic opioid usage were investigated: prescription(s) for ≥60 days between postoperative days 90-365; and ≥1 prescription during 1-90 days AND 91-180 days following surgery. Multivariable generalized estimating equation logistic regression was used to examine opioid usage predictors while accounting for surgeon clustering.
Overall, 67.4% of patients obtained early opioid prescriptions; nevertheless, persistent opioid use was modest, ranging from 1.6 to 4.4% of patients, depending on the criteria. In a multivariate study, open nephrectomy was linked to a greater risk of early opioid addiction than MIS nephrectomy (Odds Ratio [OR] 1.36, 95% [CI] 1.19-1.55). However, for either category, surgery type was not substantially related to long-term opioid usage (OR 1.22, CI 0.79-1.89 and OR 1.06, CI 0.83-1.35).
In the population-level research of patients undergoing nephrectomy for kidney cancer, those who had open surgery had a higher chance of obtaining early post-operative opioids than those who had MIS. Prolonged opioid usage was low overall and not linked with the operation.