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Association of opioid exposure during intensive care unit stays with post-discharge opioid use: A retrospective study and literature review

Yoonsun Mo, MS, PharmD, BCPS, BCCCP, John Zeibeq, MD, Nabil Mesiha, MD, Abou Bakar, PharmD, Maram Sarsour, PharmD, Michelle Liu, PharmD, James Gasperino, MD, PhD, MPH, DABT

Abstract


Objective: To evaluate whether pain management strategies within intensive care unit (ICU) settings contribute to chronic opioid use upon hospital discharge in opioid-naive patients requiring invasive mechanical ventilation.

Design: A retrospective, observational study.

Setting: An 18-bed mixed ICU at a community teaching hospital located in Brooklyn, New York.

Participants: This study included mechanically ventilated patients requiring continuous opioid infusion from April 25, 2017 to May 16, 2019. Patients were excluded if they received chronic opioid therapy at home or expired during this hospital admission. Eligible patients were identified using an electronic health record data query.

Main outcome measure(s): The proportion of ICU patients who continued to require opioids upon ICU and hospital discharge.

Results: A total of 196 ICU patients were included in this study. Of these, 22 patients were transferred to a regular floor while receiving a fentanyl transdermal patch. However, the fentanyl patch treatment was continued only for three patients (2 percent) at hospital discharge.

Conclusions: This retrospective study suggested that high-dose use of opioids in mechanically ventilated, opioid-naive ICU patients was not associated with continued opioid use upon hospital discharge.


Keywords


opioid, analgosedation, intensive care unit, pain, analgesic

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References


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DOI: https://doi.org/10.5055/jom.2021.0685

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