- Surgical patients who took both opioids and benzodiazepines within 6 months before noncardiac surgery had higher rates of short- and long-term mortality and persistent postoperative opioid consumption.
Why this matters
- Patients with a preoperative history of opioid and benzodiazepine use should be referred for medication optimization before surgery to improve outcomes.
- Study of 27,787 patients (age, ≥18 years) who underwent noncardiac surgery at a national hospital in Iceland during 2005-2015.
- Funding: Landspitali University Hospital Research Fund.
- 42,170 surgical procedures were performed.
- 17.7% of patients received opioids, 7.4% received benzodiazepines, and 6.2% received both opioids and benzodiazepines within 6 months of the procedure.
- Patients who received both opioids and benzodiazepines vs those who received no medication had significantly higher:
- 30-day mortality (3.2% vs 1.8%; P=.004) and
- long-term mortality (aHR, 1.41; P<.001>
- Compared with patients prescribed neither medication, a higher number of patients had persistent (>3 months) postoperative consumption in the:
- opioid-only group (43% vs 12%; P <.001>
- benzodiazepines-only group (23% vs 12%; P<.001 and>
- both opioid and benzodiazepines groups (66% vs 12%; P<.001>
- Retrospective, single-center study.
Coauthored with Antara Ghosh, PhD