Short- and long-term opioid use in survivors of subarachnoid hemorrhage

被引：4

作者：

Mahta, Ali ^{[1
,2
]}

Anderson, Matthew N. ^{[2
]}

Azher, Aidan, I ^{[3
]}

Mahmoud, Leana N. ^{[4
]}

Dakay, Katarina ^{[5
]}

Abdulrazeq, Hael ^{[2
]}

Abud, Alexander ^{[1
]}

Moody, Scott ^{[1
]}

Reznik, Michael E. ^{[1
,2
]}

Yaghi, Shadi ^{[1
,6
]}

Thompson, Bradford B. ^{[1
,2
]}

Wendell, Linda C. ^{[1
,2
]}

Rao, Shyam S. ^{[1
,2
]}

Potter, Nicholas S. ^{[1
,2
]}

Cutting, Shawna ^{[1
]}

Mac Grory, Brian ^{[7
]}

Stretz, Christoph ^{[1
]}

Doberstein, Curtis E. ^{[2
]}

Furie, Karen L. ^{[1
]}

机构：

[1] Brown Univ, Rhode Isl Hosp, Dept Neurol, Warren Alpert Med Sch, Providence, RI 02903 USA

[2] Brown Univ, Rhode Isl Hosp, Dept Neurosurg, Warren Alpert Med Sch, Providence, RI 02903 USA

[3] Univ Texas McGovern Med Sch, Dept Neurol, Houston, TX USA

[4] Rhode Isl Hosp, Dept Pharm, Providence, RI USA

[5] Westchester Med Ctr, Dept Neurosurg, Valhalla, NY USA

[6] NYU Langone, Dept Neurol, New York, NY USA

[7] Duke Univ, Dept Neurol, Durham, NC USA

来源：

CLINICAL NEUROLOGY AND NEUROSURGERY | 2021年 / 207卷

关键词：

Opioid; Subarachnoid hemorrhage; Pain; Headache; HEADACHE; CRISIS; VASOSPASM;

D O I：

10.1016/j.clineuro.2021.106770

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objectives: Opioids are frequently used for analgesia in patients with acute subarachnoid hemorrhage (SAH) due to a high prevalence of headache and neck pain. However, it is unclear if this practice may pose a risk for opioid dependence, as long-term opioid use in this population remains unknown. We sought to determine the prevalence of opioid use in SAH survivors, and to identify potential risk factors for opioid utilization. Methods: We analyzed a cohort of consecutive patients admitted with non-traumatic and suspected aneurysmal SAH to an academic referral center. We included patients who survived hospitalization and excluded those who were not opioid-naive. Potential risk factors for opioid prescription at discharge, 3 and 12 months post-discharge were assessed. Results: Of 240 SAH patients who met our inclusion criteria (mean age 58.4 years [SD 14.8], 58% women), 233 (97%) received opioids during hospitalization and 152 (63%) received opioid prescription at discharge. Twentyeight patients (12%) still continued to use opioids at 3 months post-discharge, and 13 patients (6%) at 12-month follow up. Although patients with poor Hunt and Hess grades (odds ratio 0.19, 95% CI 0.06-0.57) and those with intraventricular hemorrhage (odds ratio 0.38, 95% CI 0.18-0.87) were less likely to receive opioid prescriptions at discharge, we did not find significant differences between patients who had long-term opioid use and those who did not. Conclusion: Opioids are regularly used in both the acute SAH setting and immediately after discharge. A considerable number of patients also continue to use opioids in the long-term. Opioid-sparing pain control strategies should be explored in the future.

引用

页数：6

共 27 条

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