| 英文摘要 |
Background: Persistent postoperative opioid use is a rising concern that may lead to higher risks of opioid dependence and related adverse outcomes. With smaller incisions, minimally invasive surgery is considered related to less postoperative pain and improved recovery. However, there is limited research addressing persistent opioid use after minimally invasive surgery. In this study, we aimed to compare persistent postoperative opioid use between traditional surgery and minimally invasive surgery using data retrieved from the National Health Research Database in Taiwan.
Methods: From 2004–2016, a total of 121,127 patients who underwent herniorrhaphy; hepatectomy; cholecystectomy; appendectomy; colorectal, gastric, gynecological, thoracic or renal surgeries with either traditional or minimally invasive approaches were enrolled. We stratified the participants by surgery type and compared the incidence of persistent opioid use over 90 days after surgery between the two approaches. The adjusted odds ratios (aORs) with 95% confi dence intervals (CIs) were estimated using multivariable logistic regression analysis.
Results: After adjusted for age, sex, hospital level, and comorbidities, traditional approach was associated with higher odds for persistent postoperative opioid use than minimally invasive approach in herniorrhaphy (aOR, 3.00; 95% CI, 1.08–8.37); cholecystectomy (aOR, 1.86; 95% CI, 1.38–2.52); gastric (aOR, 1.91; 95% CI, 1.56–2.34), thoracic (aOR, 1.47; 95% CI, 1.09–1.99), and renal surgeries (aOR, 1.83; 95% CI, 1.13–2.98).
Conclusion: The minimally invasive approach was independently associated with a lower risk of persistent postoperative opioid use after herniorrhaphy; cholecystectomy; gastric, thoracic, and renal surgery compared to the traditional approach. |
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