Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Purpose: Treatment of preoperative depression has been shown to reduce pain perception and disability after spine surgery, which encouraged utilizing antidepressants as a treatment for pain. Though opioid consumption after spine surgery has been well studied, few studies have investigated its association with medications such as antidepressants and gabapentinoids. Therefore, our study investigated the relationship between antidepressants, gabapentinoids and opioid consumption after lumbar fusion.
Methods: After Institutional Review Board (IRB) approval, patients undergoing elective lumbar fusion from 2017 to 2021 at a single, academic, tertiary care center were identified. Patients were determined to be taking an antidepressant or gabapentinoid if they had these medications listed as active in their preoperative and first postoperative appointments. Opioid consumption before and after surgery was collected through the state Prescription Drug Monitoring Program (PDMP). Statistics were performed to compare patients across groups.
Results: 411 patients were identified that underwent elective lumbar fusion with complete patient-reported outcomes and PDMP data. On multivariable analysis, preoperative morphine milligram equivalents (MMEs) were an independent predictor of postoperative MME/day at all postoperative time points. Perioperative SNRI use was predictive of increased 90-180 day MME/day (p = 0.019). Perioperative gabapentinoid use was predictive of increased MME/day at 30-90 days (p = 0.034) and 180-365 days (p = 0.024).
Conclusion: A complex relationship exists between the medical management of mood disorders and neuropathic pain using antidepressants, anxiolytics, and gabapentinoids for patients undergoing spinal surgery. Patients prescribed gabapentinoids and SNRIs are at increased risk of opioid use postoperatively while patients taking SSRIs do not demonstrate such increased risk.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00586-025-08764-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Polydrug abuse: Choice between drugs as a function of concurrent nonindependent ratio sizes.
J Exp Anal Behav
September 2025
Faillace Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, USA.
Polydrug abuse is the persistent self-administration of more than one reinforcing drug. The present study provided rhesus monkeys concurrent access to two drugs: 8% alcohol and solutions of either cocaine or methadone. The liquids were available under concurrent nonindependent fixed-ratio (FR) schedules across increasing and then decreasing ratio sizes.
View Article and Find Full Text PDFImpact of preoperative quadratus lumborum block on postoperative opioid consumption after laparoscopic hysterectomy: a double-blind randomized controlled trial.
Pain Manag
September 2025
Minimally Invasive Gynecologic Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Background: Gynecologic enhanced recovery after surgery (ERAS) pathways have been developed to reduce postoperative narcotic use through multimodal pain management. While incisional injection of local anesthetic is standard practice, regional nerve blockades using liposomal agents are emerging as a promising adjunct technique for post-laparoscopy pain. Current data are conflicting regarding the benefits of regional nerve blocks on postoperative pain after laparoscopic hysterectomy.
View Article and Find Full Text PDFPostoperative Analgesic Effects of Anterior Quadratus Lumborum Block vs Intravenous Analgesics Administered to Donors and Recipients in Renal Transplantation Surgery: A Prospective Cohort Study.
Ann Transplant
September 2025
Department of Anesthesiology and Reanimation, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
BACKGROUND Among the limited analgesic options, plane blocks are of great importance in providing effective postoperative analgesia to donors and recipients in renal transplantation surgery. We aimed to demonstrate that anterior type quadratus lumborum plane block provides better analgesia than intravenous paracetamol in open and closed nephrectomy patients. MATERIAL AND METHODS We conducted a prospective cohort study.
View Article and Find Full Text PDFEffect of virtual reality on perioperative anxiety, stress and pain in total hip arthroplasty: a randomized controlled trial.
BMC Anesthesiol
September 2025
Faculty of Medicine, Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Tanta University, Tanta, El Gharbia, 31511, Egypt.
Background: Virtual reality (VR) has shown promise as a nonpharmacological alternative to pharmaceutical pain relievers and anxiety medications in clinical trials by decreasing pain and anxiety in orthopedic surgeries. The aim of the study was to evaluate the impact of VR on these outcomes in individuals undergoing total hip arthroplasty (THA).
Methods: This randomized, controlled, open-label research included 50 participants planned for THA with spinal anesthesia (SA).
Intravenous methocarbamol for acute pain after spine surgery: a target trial emulation.
Reg Anesth Pain Med
September 2025
Center for Outcomes Research and Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School at UTHealth Houston, Houston, Texas, USA.
Background: Skeletal muscle relaxants are often included in multimodal analgesic regimens following spine surgery, but their actual effectiveness remains unclear due to limited and inconsistent evidence. We aimed to evaluate the effectiveness of intravenous methocarbamol in reducing acute postoperative pain and opioid consumption after elective spine surgery.
Methods: This emulated target trial used electronic health record data from patients undergoing elective spine surgery (posterior spinal fusion, anterior cervical discectomy and fusion, laminectomy/laminotomy) between January 1, 2020 and December 31, 2023.