• Pain Med · Dec 2020

    Meta Analysis

    Gender Differences in Preoperative Opioid Use in Spine Surgery Patients: A Systematic Review and Meta-analysis.

    • Chung-Wang Lee, Yu Tung Lo, Sharmila Devi, Yookyung Seo, Angela Simon, Kelsey Zborovancik, Mona Y Alsheikh, Nayan Lamba, Timothy R Smith, Rania A Mekary, and Linda S Aglio.
    • School of Pharmacy, MCPHS University, Boston, Massachusetts.
    • Pain Med. 2020 Dec 25; 21 (12): 3292-3300.

    ObjectiveOpioids are frequently used in spine surgeries despite their adverse effects, including physical dependence and addiction. Gender difference is an important consideration for personalized treatment. There is no review assessing the prevalence of opioid use between men and women before spine surgeries.DesignWe compared the prevalence of preoperative opioid use between men and women.SettingSpine surgery.SubjectsComparison between men and women.MethodsPubMed, Embase, and Cochrane were searched from inception to November 9, 2018. Clinical characteristics and prevalence of preoperative opioid use were collected. Where feasible, data were pooled from nonoverlapping studies using random-effects models.ResultsFour studies with nonoverlapping populations were included in the meta-analysis (one prospective, three retrospective cohorts). The prevalence of preoperative opioid use was 0.64 (95% CI = 0.40-0.83). Comparing men with women, no statistically significant difference in preoperative opioid use was detected (relative risk [RR] = 0.99, 95% CI = 0.96-1.02). Surgery location (cervical, lumbar) and study duration (more than five years or five years or less) did not modify this association. All involved open spine surgery. Only one secondary analysis provided data on both pre- and postoperative opioid use stratified by gender, which showed a borderline significantly higher prevalence of postoperative use in women than men.ConclusionsThe prevalence of opioid use before spine surgery was similar between men and women, irrespective of surgery location or study duration. More studies characterizing the pattern of opioid use between genders are still needed.© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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