Study links intraoperative synthetic opioids, worse postoperative pain

Editor's Note

Using powerful synthetic opioids remifentanil and sufentanil during surgery increases risk of patients suffering during recovery, according to a study in the journal Regional Anesthesia & Pain Medicine. HealthDay reported the news February 27.

According to the article, researchers analyzed data from 971 patients who underwent surgery—37% orthopedic or spinal, 29% ear nose or throat, and 15% digestive)—at five French teaching hospitals. Patients were randomly assigned to receive either the sedative lorazepam, a placebo, or no preoperative medication the day before surgery. Of those patients, 271 (28%) reported a poor “pain experience”—a composite of the emotional, cognitive and mental aspects of pain—on the first day after surgery.

Administering opioids to patients under general anesthesia increased the risk by a factor of about 27, HealthDay reports. These findings are consistent with the phenomenon of opioid-induced hyperalgesia, a paradoxical effect in which opioids reduce pain during surgery but exacerbate pain sensitivity afterward.

Other findings include:

• Patients with severe chronic illness were 5 times more likely to experience serious pain.
• Postoperative anxiety drugs increased the risk of serious pain by 8 times.
• Patients given no preoperative sedatives were 51% less likely to experience pain.
• Patients undergoing orthopedic surgery were 71% less likely to have pain.