Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspective
Objective: To evaluate trends in the use of epidural analgesia and nonopioid and opioid analgesics for patients undergoing lobectomy from 2009 to 2018. Methods: We queried the Premier database for adult patients undergoing open, video-assisted, and robotic-assisted lobectomy from 2009 to 2018. The o...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666273621000723 |
| _version_ | 1830230603172151296 |
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| author | Theresa Lo, MD Robin Schiller, MD, DMD Karthik Raghunathan, MBBS, MPH Vijay Krishnamoorthy, MD, MPH, PhD Oliver K. Jawitz, MD, MHS Srinivas Pyati, MBBS, MD, FCARCSI Thomas Van De Ven, MD, PhD Raquel R. Bartz, MD Annemarie Thompson, MD Tetsu Ohnuma, MD, MPH, PhD |
| author_facet | Theresa Lo, MD Robin Schiller, MD, DMD Karthik Raghunathan, MBBS, MPH Vijay Krishnamoorthy, MD, MPH, PhD Oliver K. Jawitz, MD, MHS Srinivas Pyati, MBBS, MD, FCARCSI Thomas Van De Ven, MD, PhD Raquel R. Bartz, MD Annemarie Thompson, MD Tetsu Ohnuma, MD, MPH, PhD |
| author_sort | Theresa Lo, MD |
| collection | DOAJ |
| description | Objective: To evaluate trends in the use of epidural analgesia and nonopioid and opioid analgesics for patients undergoing lobectomy from 2009 to 2018. Methods: We queried the Premier database for adult patients undergoing open, video-assisted, and robotic-assisted lobectomy from 2009 to 2018. The outcome of interest was changes in the receipt of epidural analgesia and nonopioid and opioid analgesics as measured by charges on the day of surgery. We also evaluated postoperative daily opioid use. We used multivariable logistic and linear regression models to examine the association between the utilization of each analgesic modality and year. Results: We identified 86,308 patients undergoing lobectomy from 2009 to 2018 within the Premier database: 35,818 (41.5%) patients had open lobectomy, 35,951 (41.7%) patients had video-assisted lobectomy, and 14,539 (16.8%) patients had robotic-assisted lobectomy. For all 3 surgical cohorts, epidural analgesia use decreased, and nonopioid analgesics use increased over time, except for intravenous nonsteroidal anti-inflammatory drugs. Use of patient-controlled analgesia decreased, while opioid consumption on the day of surgery increased and postoperative opioid consumption did not decrease over time. Conclusions: In this large sample of patients undergoing lobectomy, utilization of epidural analgesia declined and use of nonopioid analgesics increased. Despite these changes, opioid consumption on day of surgery increased, and there was no significant reduction in postoperative opioid consumption. Further research is warranted to examine the association of these changes with patient outcomes. |
| first_indexed | 2024-12-18T10:56:21Z |
| format | Article |
| id | doaj.art-db2d14518ec7450e936d0499a55f21dc |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-12-18T10:56:21Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-db2d14518ec7450e936d0499a55f21dc2022-12-21T21:10:19ZengElsevierJTCVS Open2666-27362021-06-016224236Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspectiveTheresa Lo, MD0Robin Schiller, MD, DMD1Karthik Raghunathan, MBBS, MPH2Vijay Krishnamoorthy, MD, MPH, PhD3Oliver K. Jawitz, MD, MHS4Srinivas Pyati, MBBS, MD, FCARCSI5Thomas Van De Ven, MD, PhD6Raquel R. Bartz, MD7Annemarie Thompson, MD8Tetsu Ohnuma, MD, MPH, PhD9Critical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Veterans Affairs Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NCDivision of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Veterans Affairs Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Veterans Affairs Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Duke University Medical Center, Durham, NCCritical Care and Perioperative Population Health Research (CAPER) Unit, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Division of Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Durham, NC; Address for reprints: Tetsu Ohnuma, MD, MPH, PhD, Department of Anesthesiology, Duke University, DUMC 3094, Durham, NC 27710.Objective: To evaluate trends in the use of epidural analgesia and nonopioid and opioid analgesics for patients undergoing lobectomy from 2009 to 2018. Methods: We queried the Premier database for adult patients undergoing open, video-assisted, and robotic-assisted lobectomy from 2009 to 2018. The outcome of interest was changes in the receipt of epidural analgesia and nonopioid and opioid analgesics as measured by charges on the day of surgery. We also evaluated postoperative daily opioid use. We used multivariable logistic and linear regression models to examine the association between the utilization of each analgesic modality and year. Results: We identified 86,308 patients undergoing lobectomy from 2009 to 2018 within the Premier database: 35,818 (41.5%) patients had open lobectomy, 35,951 (41.7%) patients had video-assisted lobectomy, and 14,539 (16.8%) patients had robotic-assisted lobectomy. For all 3 surgical cohorts, epidural analgesia use decreased, and nonopioid analgesics use increased over time, except for intravenous nonsteroidal anti-inflammatory drugs. Use of patient-controlled analgesia decreased, while opioid consumption on the day of surgery increased and postoperative opioid consumption did not decrease over time. Conclusions: In this large sample of patients undergoing lobectomy, utilization of epidural analgesia declined and use of nonopioid analgesics increased. Despite these changes, opioid consumption on day of surgery increased, and there was no significant reduction in postoperative opioid consumption. Further research is warranted to examine the association of these changes with patient outcomes.http://www.sciencedirect.com/science/article/pii/S2666273621000723multimodal analgesiaepidural analgesianonopioid analgesiathoracic surgerylobectomythoracotomy |
| spellingShingle | Theresa Lo, MD Robin Schiller, MD, DMD Karthik Raghunathan, MBBS, MPH Vijay Krishnamoorthy, MD, MPH, PhD Oliver K. Jawitz, MD, MHS Srinivas Pyati, MBBS, MD, FCARCSI Thomas Van De Ven, MD, PhD Raquel R. Bartz, MD Annemarie Thompson, MD Tetsu Ohnuma, MD, MPH, PhD Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspective JTCVS Open multimodal analgesia epidural analgesia nonopioid analgesia thoracic surgery lobectomy thoracotomy |
| title | Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspective |
| title_full | Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspective |
| title_fullStr | Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspective |
| title_full_unstemmed | Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspective |
| title_short | Changes in analgesic strategies for lobectomy from 2009 to 2018Central MessagePerspective |
| title_sort | changes in analgesic strategies for lobectomy from 2009 to 2018central messageperspective |
| topic | multimodal analgesia epidural analgesia nonopioid analgesia thoracic surgery lobectomy thoracotomy |
| url | http://www.sciencedirect.com/science/article/pii/S2666273621000723 |
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