Opioid analgesic effects on subjective well-being in the operating theatre.
Détails
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Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
Etat: Public
Version: Final published version
Licence: CC BY-NC-ND 4.0
ID Serval
serval:BIB_AE352267E415
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Opioid analgesic effects on subjective well-being in the operating theatre.
Périodique
Anaesthesia
ISSN
1365-2044 (Electronic)
ISSN-L
0003-2409
Statut éditorial
Publié
Date de publication
09/2023
Peer-reviewed
Oui
Volume
78
Numéro
9
Pages
1102-1111
Langue
anglais
Notes
Publication types: Observational Study ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
Exposure to opioid analgesics due to surgery increases the risk of new persistent opioid use. A mechanistic hypothesis for opioids' abuse liability rests on the belief that, in addition to pain relief, acute opioid treatment improves well-being (e.g. via euphoria) and relieves anxiety. However, opioids do not consistently improve mood in laboratory studies of healthy non-opioid users. This observational study determined how two commonly used opioid analgesics affected patients' subjective well-being in standard clinical practice. Day surgery patients rated how good and how anxious they felt before and after an open-label infusion of remifentanil (n = 159) or oxycodone (n = 110) in the operating theatre before general anaesthesia. One minute after drug injection, patients reported feeling intoxicated (> 6/10 points). Anxiety was reduced after opioids, but this anxiolytic effect was modest (remifentanil Cohen's d = 0.21; oxycodone d = 0.31). There was moderate to strong evidence against a concurrent improvement in well-being (Bayes factors > 6). After remifentanil, ratings of 'feeling good' were significantly reduced from pre-drug ratings (d = 0.28). After oxycodone, one in three participants felt better than pre-drug. Exploratory ordered logistic regressions revealed a link between previous opioid exposure and opioid effects on well-being, as only 14 of the 80 opioid-naïve patients reported feeling better after opioid injection. The odds of improved well-being ratings after opioids were higher in patients with previous opioid exposure and highest in patients with > 2 weeks previous opioid use (adjusted OR = 4.4). These data suggest that opioid-induced improvement of well-being is infrequent in opioid-naïve patients. We speculate that peri-operative exposure could increase risk of persistent use by rendering subsequent positive opioid effects on well-being more likely.
Mots-clé
Humans, Analgesics, Opioid, Oxycodone/therapeutic use, Remifentanil, Bayes Theorem, Opioid-Related Disorders/prevention & control, affect, emotion, euphoria, mood, pain, relief, reward, well-being
Pubmed
Web of science
Open Access
Oui
Création de la notice
03/07/2023 15:27
Dernière modification de la notice
13/12/2023 7:22