SynthesisAnesthesia and analgesia2019
American Society for Enhanced Recovery and Perioperative Quality Initiative-4 Joint Consensus Statement on Persistent Postoperative Opioid Use: Definition, Incidence, Risk Factors, and Health Care System Initiatives.
Synthesis in Anesthesia and analgesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04625283 (The Effect and Contribution of a Perioperative Ketamine Infusion in an Established Enhanced Recovery Pathway), which is not on this map. Cited by 64 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect and Contribution of a Perioperative Ketamine Infusion in an Established Enhanced Recovery Pathway
Who cites it
64 citing papers in PubMed, 4 syntheses or guidelines pooled it, 152 citations in OpenAlex.
- Patient-related risk factors for new persistent opioid use after surgery among opioid-naïve individuals in the United States: a systematic review and meta-analysis.Pain medicine (Malden, Mass.) · 2026Pooled it
- Incidence and risk factors of new persistent opioid use after surgery and trauma: A systematic review.BMC surgery · 2024Pooled it
- Elective surgery in ankle and foot disorders-best practices for management of pain: a guideline for clinicians.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2022Guideline
- Persistent Postoperative Opioid Use: A Systematic Literature Search of Definitions and Population-based Cohort Study.Anesthesiology · 2020Pooled it
- Perioperative Intravenous Dexamethasone Significantly Reduces Postoperative Opioid Requirement and Nausea After Unilateral Elective Hip Arthroscopy: A Randomized Double-blinded Placebo-controlled Trial.The American journal of sports medicine · 2024Trial
- Effect of Smartphone App-Based Education on Clinician Prescribing Habits in a Learning Health Care System: A Randomized Cluster Crossover Trial.JAMA network open · 2022Trial
- CYP2D6 Metabolizer Phenotype and New Persistent Opioid Use After Spine Surgery.Global spine journal · 2026Article
- A Multidisciplinary Approach to Reduce Prolonged Postoperative Opioid Use in High-risk Patients.Journal of general internal medicine · 2026Article
- Postoperative Opioid Use After Bariatric Surgery and Associated Factors: A Retrospective Comparison of Laparoscopic and Robotic Approaches.Journal of clinical medicine · 2026Article
- Call to Action: The Hidden Role of Anesthesiologists in the Opioid Epidemic.Anesthesia and analgesia · 2026Article
- The persistence of chronic opioid use in patients with inflammatory bowel disease-A nationwide cohort study.British journal of clinical pharmacology · 2026Article
- Prevalence, Trajectories, and Predictors of Persistent Postoperative Opioid Use in a Swiss University Hospital: A Prospective Observational Study.Journal of pain research · 2026Article
- Prediction Model for Factors Associated With Long-Term Opioid Use Following Total Knee Arthroplasty: A Retrospective Population-Based Study.European journal of pain (London, England) · 2026Article
- Review
- Opioid consumption after lower limb amputation in Medicare beneficiaries.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Postoperative Opioid Receipt After Parotidectomy and Associations With Persistent Opioid Use Disorder.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2025Article
- Post-Thyroidectomy Opioid Prescription and Risk of Persistent Opioid Use: A Propensity Matched Cohort Study.Head & neck · 2025Article
- Surgeons' opinions about enhanced recovery after surgery for retroperitoneal sarcoma: A survey.World journal of clinical oncology · 2025Article
- Association between preoperative obstructive sleep apnea diagnosis and prolonged postoperative opioid use among patients undergoing common surgical procedures.Regional anesthesia and pain medicine · 2025Article
- Review
4 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
12 authors at 9 institutions in 3 countries.
Funding
Abstract
Persistent postoperative opioid use is thought to contribute to the ongoing opioid epidemic in the United States. However, efforts to study and address the issue have been stymied by the lack of a standard definition, which has also hampered efforts to measure the incidence of and risk factors for persistent postoperative opioid use. The objective of this systematic review is to (1) determine a clinically relevant definition of persistent postoperative opioid use, and (2) characterize its incidence and risk factors for several common surgeries. Our approach leveraged a group of international experts from the Perioperative Quality Initiative-4, a consensus-building conference that included representation from anesthesiology, surgery, and nursing. A search of the medical literature yielded 46 articles addressing persistent postoperative opioid use in adults after arthroplasty, abdominopelvic surgery, spine surgery, thoracic surgery, mastectomy, and thoracic surgery. In opioid-naïve patients, the overall incidence ranged from 2% to 6% based on moderate-level evidence. However, patients who use opioids preoperatively had an incidence of >30%. Preoperative opioid use, depression, factors associated with the diagnosis of substance use disorder, preoperative pain, and tobacco use were reported risk factors. In addition, while anxiety, sex, and psychotropic prescription are associated with persistent postoperative opioid use, these reports are based on lower level evidence. While few articles addressed the health policy or prescriber characteristics that influence persistent postoperative opioid use, efforts to modify prescriber behaviors and health system characteristics are likely to have success in reducing persistent postoperative opioid use.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.