Effect of pre-operative opioid exposure on surgical outcomes in elective laparoscopic cholecystectomy

Background: The effects of varying levels of pre-operative opioids on post-operative outcomes following elective laparoscopic cholecystectomy is largely unknown. Methods: Patients who underwent elective laparoscopic cholecystectomy from 2012 to 2019 were reviewed and categorized by the number of outpatient opioid prescriptions received in the 90 days preceding surgery: none (Naive), one (1 Rx), two (2 Rx), or three or more (Chronic). Operative time, hospital length of stay, and 30-day readmission rate were analyzed. Results: Of the 11911 patients identified, 2958 (24.8%) used opioids pre-operatively. Among patients with an overnight admission, the Naive, 1 Rx, and 2 Rx cohorts had a shorter length of stay compared to the Chronic cohort. The Naive group had the lowest 30-day readmission rate (5.0%) followed by the 1 Rx (5.9%), 2 Rx and Chronic groups (9.1% and 8.7%, respectively) (p < 0.001). Conclusions: Prevalence of pre-operative opioid use is high and warrants surgeon assessment to mini-mize adverse post-operative outcomes.(c) 2021 Elsevier Inc. All rights reserved.

Automated summary

This study aimed to investigate the effects of pre-operative opioid use on post-operative outcomes in patients undergoing elective laparoscopic cholecystectomy. The results showed a high prevalence of pre-operative opioid use and a positive correlation between the number of opioid prescriptions and length of hospital stay and readmission rate. Surgeons should assess pre-operative opioid use to minimize adverse post-operative outcomes.