Chronic preoperative opioid use may be associated with persistent opioid use as high as 20% seven years after bariatric surgery. The aim of our study was to assess long term opioid use following bariatric surgery in patients on preoperative opioids.
We evaluated patients utilizing preoperative opioids (OP) who underwent primary laparoscopic Roux-en-Y gastric bypass from 2013 to 2018. Patients were propensity matched to those without preoperative opioid use (NOP) by demographics and comorbidities from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP). Statistical analysis was performed using Paired t-test, McNemar's test and Wilcoxon signed rank sum test.
950 patients, matched 1:1 were evaluated with no statistically significant difference in sex, American Society of Anesthesiologist (ASA) classification and comorbidities. Patients were clinically similar for age and preoperative weight and body mass index (BMI). All patients were followed for at least 1 year after surgery. The overall 3 year follow up of the entire cohort was 35%. In the OP group, 55% had a 3 year follow up. 82.3% of patients in OP and 99.2% in NOP had stopped using opiates after 1 year, while 94.9% and 99.2% were not using opioids at 3 years. There were no mortalities.
The majority of patients with preoperative opioid requirements will discontinue their use long term after bariatric surgery. Chronic preoperative opioid use does not increase postoperative readmissions or emergency room visits.