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Association of opioid exposure before surgery with opioid consumption after surgery: an infographic
  1. Eric S Schwenk1,
  2. Rajnish K Gupta2 and
  3. Mark C Bicket3
  1. 1 Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
  2. 2 Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  3. 3 Anesthesiology, University of Michigan Medicine, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Eric S Schwenk, Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA; prepdrum{at}

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In this retrospective cohort study by Bicket et al,1 the authors studied 26,001 patients from 70 hospitals to determine if an association exists between preoperative opioid exposure and postoperative opioid consumption. Unlike most previous studies that relied on prescriptions filled to quantify postoperative opioid use, this study was able to report on the number of opioid pills actually consumed by patient self-report. Patients were grouped into four categories based on preoperative opioid exposure: naïve, minimal, intermittent, and chronic. The authors found that the number of postoperative oral morphine equivalents consumed after having elective general or gynecological surgery increased from 31 (naïve) to 36 (minimal) to 48 (intermittent) and finally 63 (chronic). This translated to 4.1, 4.8, 6.4, and 8.4 pills, respectively. Additionally, postoperative opioid refills were greater in patients who used preoperative opioids.

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The authors wish to acknowledge Jim Snively, artist, of Pittsburgh, PA, for graphic design of this infographic.



  • Twitter @ESchwenkMD, @dr_rajgupta, @MarkBicket

  • Contributors All authors contributed equally to the infographic.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Drs ESS and RKG are social media editors for RAPM.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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