Preop opioid, benzodiazepine use linked to postop mortality, opioid consumption

Editor's Note

Use of opioids and benzodiazepines 6 months before surgery was associated with increased short- and long-term mortality and an increased rate of persistent postoperative opioid consumption, this study finds.

In this analysis of 41,170 noncardiac surgical cases in 27,787 patients in Iceland, preoperative prescriptions for opioids only were filled for 7,460 cases, benzodiazepines only for 3,121, and both opioids and benzodiazepines for 2,633.

Patients who filled preoperative prescriptions for either medication had a greater comorbidity burden than those receiving neither medication.

Patients prescribed both opioids and benzodiazepines had greater 30-day mortality (3.2% vs 1.8%) and a greater hazard of long-term mortality.

Persistent postoperative opioid consumption was higher for patients filling prescriptions for opioids only (43%), benzodiazepines only (23%), or both (66%), compared with patients filling neither (12%).

This group of patients should be considered for preoperative intervention to limit the potential harm of these medications postoperatively, the researchers say.