SummaryBackgroundThe risk of chronic opioid use after surgery for Crohn's disease (CD) is not known.AimThe aim of this study is to examine the chronic opioid use after surgery according to age at time of surgery and to opioid use prior to surgery.MethodsThis nationwide cohort study included patients with a first surgery for CD (January 1, 1996 through 2021). We examined prescribed opioids 9 months after surgery and estimated adjusted odds ratios (OR) for chronic opioid use in elderly (≥60 years), adults (≥40 and <60 years), and young adults (≥18 and <40 years) according to opioid use prior to surgery. Chronic opioid use was defined as prescriptions in at least two of three consecutive quarters.ResultsA total of 797 patients had surgery as elderly, 1603 as adults, and 2786 as young adults. Across all age groups, 18%–38% received opioid prescriptions throughout 9 months after surgery, if opioids were prescribed prior to surgery. If opioids were not prescribed prior to surgery, the corresponding proportions were 2%–5%. If patients were prescribed opioids (≥1) prior to surgery, the adjusted ORs (95% CIs) for their chronic use after surgery in elderly, adults, and young adults were 10.37 (6.77–15.88), 10.48 (7.74–14.19), and 6.55 (4.93–8.72), respectively.ConclusionClinicians should be aware that in patients with a need for opioids before surgery, the surgery may not change the need for opioids. Future research should examine effective analgesic strategies that help minimise opioid use in this population.

中文翻译：

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克罗恩病手术后九个月使用阿片类药物——一项全国性队列研究

摘要背景克罗恩病 (CD) 手术后长期使用阿片类药物的风险尚不清楚。目的本研究的目的是根据手术时的年龄和手术前阿片类药物的使用情况来检查手术后慢性阿片类药物的使用情况。方法这个全国性队列研究纳入了首次接受 CD 手术的患者（1996 年 1 月 1 日至 2021 年）。我们在手术后 9 个月检查了处方阿片类药物，并根据老年人（≥60 岁）、成人（≥40 岁且 <60 岁）和年轻人（≥18 岁且 <40 岁）的慢性阿片类药物使用情况估计了调整后的比值比 (OR)。手术前使用阿片类药物。慢性阿片类药物使用被定义为连续三个季度中至少有两个季度开具处方。结果共有 797 名老年患者、1603 名成人和 2786 名年轻患者接受了手术。在所有年龄组中，如果在手术前开了阿片类药物，则 18%–38% 的人在手术后 9 个月内接受阿片类药物处方。如果术前未处方阿片类药物，相应比例为 2%–5%。如果患者在手术前服用阿片类药物（≥1），则老年人、成人和年轻人术后长期使用的调整后 OR（95% CI）分别为 10.37（6.77–15.88）、10.48（7.74–14.19）、和 6.55 (4.93–8.72)。结论临床医生应该意识到，对于手术前需要阿片类药物的患者，手术可能不会改变对阿片类药物的需求。未来的研究应该研究有效的镇痛策略，以帮助最大限度地减少该人群中阿片类药物的使用。