Table 1.
Study | Surgery type | Sample size | Mean (age) | Female (%) | Sample with pre-operative opioid use (%) | Region | Opioid outcome | Method | Postop day | Risk of bias |
---|---|---|---|---|---|---|---|---|---|---|
Alter and Ilyas [48] | Carpel tunnel release | 20 | 62 | 70 | 0 | Midwest | Pills | Mean | 3 | L |
As-Sanie, et al. [49] | Hysterectomy | 102 | 49 | 100 | 12 | Midwest | MME | Median | 14 | L |
Minimally invasive | 86 | |||||||||
Open | 16 | |||||||||
Bateman, et al. [8] | Cesarean section | 615 | 33 | 100 | Multiple | Pills | Median | 14 | L | |
Bates et al. [50] | Urologic surgery | 226 | West | Pills | Mean | 28 | M | |||
Beck et al. [51] | ACL reconstruction | 125 | 33.5 | 48 | Midwest | Pills | Mean | 7 | M | |
Cabo et al. [52] | Urologic surgery | 77 | 62.9 | 35 | 16 | South | MME | Median | 21 | M |
Chapman et al. [53] | Carpal tunnel release | 277 | 64.6 | 56 | Northeast | Pills | Mean | -- | H | |
Cunningham et al. [54] | Hip arthroscopy | 73 | 36.5 | 75 | 22 | South | Pills and MME | Mean | 42 | L |
Fujii et al. [4] | Various surgeries | 333 | 58 | Northeast | MME | Median | 7 | M | ||
Partial mastectomy; | 21 | 62.9 | 96 | 0 | ||||||
Umbilical hernia repair (open) | 16 | 49 | 42 | 5 | ||||||
Appendectomy (lap) | 17 | 41.6 | 56 | 0 | ||||||
Cholecystectomy (lap) | 40 | 51.3 | 70 | 2.5 | ||||||
Inguinal hernia repair (open) | 25 | 59.5 | 0 | 0 | ||||||
Carpal tunnel release | 28 | 60.8 | 63 | 0 | ||||||
Knee arthroscopy | 30 | 42 | 47 | 3 | ||||||
Shoulder arthroscopy | 23 | 57.4 | 36 | 12 | ||||||
Total hip arthroplasty | 45 | 61.3 | 48 | 20 | ||||||
Total knee arthroplasty | 31 | 65 | 56 | 6 | ||||||
Vasectomy | 11 | 38.8 | 0 | 0 | ||||||
Endoscopy | 29 | 58.5 | 48 | 19 | ||||||
Prostatectomy (lap) | 17 | 62.8 | 0 | 0 | ||||||
Griffith et al. [55] | Hysterectomy | 53 | Northeast | Pills | Mean | 300 | M | |||
Minimally invasive | 39 | 60.6 | 100 | |||||||
Open | 14 | 32 | 100 | |||||||
Gupta et al. [56] | Foot and ankle surgery | 84 | 47 | 66 | 0 | Northeast | Pills | Mean | 14 | M |
Harris et al. [57] | Dermatologic surgery | 212 | 68 | 28 | West | Pills | Mean | 4 | M | |
Hart et al. [58] | Breast surgery | 95 | 60.4 | 100 | South | Pills | Mean | 30 | H | |
Hartford et al. [59] | Abdominal surgery | 171 | 50 | 47 | Canada | Pills and MME | Mean | 21 | L | |
Cholecystectomy (lap) | 84 | |||||||||
Open hernia repair | 87 | 0 | ||||||||
Hill et al. [5] | Various surgeries | 127 | 0 | Northeast | Pills | Median | -- | M | ||
Partial mastectomy | 20 | 0 | ||||||||
Partial mast/node biopsy | 21 | 0 | ||||||||
Cholecystectomy (lap) | 48 | 0 | ||||||||
Inguinal hernia repair (lap) | 20 | 0 | ||||||||
Inguinal hernia repair (open) | 18 | 0 | ||||||||
Hill et al. [60] | Various surgeries | 234 | 63 | 0 | Northeast | Pills | Mean | -- | M | |
Bariatric | 83 | 0 | ||||||||
Foregut | 33 | 0 | ||||||||
Hepatectomy | 12 | 0 | ||||||||
Pancreatectomy | 10 | 0 | ||||||||
Colectomy | 69 | 0 | ||||||||
Ventral hernia | 27 | 0 | ||||||||
Hota et al. [61] | Gynecologic and pelvic reconstructive surgery | 51 | 53 | 100 | Northeast | Pills | Median | 14 | M | |
Major | 2 | |||||||||
Minor | 49 | |||||||||
Howard, Fry et al. [6] | Various surgeries | 2392 | Midwest | Pills and MME | Median | 30-120 | M | |||
Cholecystectomy (lap) | 603 | 51.2 | 71 | |||||||
Appendectomy (lap) | 224 | 44.6 | 53 | |||||||
Inguinal and femoral hernia repair (open or lap) | 659 | 58 | 19 | |||||||
Open incisional hernia repair | 159 | 60.1 | 57 | |||||||
Colectomy (lap) | 112 | 63.5 | 56 | |||||||
Open colectomy | 102 | 64.7 | 55 | |||||||
Ileostomy and colostomy takedown | 59 | 57.9 | 42 | |||||||
Small-bowel resection and/or enterolysis | 33 | 68 | 58 | |||||||
Thyroidectomy | 40 | 56 | 83 | |||||||
Vaginal hysterectomy | 113 | 51.7 | 100 | |||||||
Hysterectomy (lap) | 203 | 49.7 | 100 | |||||||
Abdominal hysterectomy | 85 | 51.5 | 100 | |||||||
Howard, Waljee et al. [62] | Cholecystectomy (lap) | 100 | 46 | 78 | Midwest | Pills and MME | Median | < 365 | H | |
Ilyas et al. [63] | Carpal tunnel release | 37 | Northeast | Pills | Mean | 5 | L | |||
Minimally invasive | 19 | 59 | 42 | 0 | ||||||
Open | 18 | 61 | 67 | 0 | ||||||
Kim et al. [15•] | Upper extremity surgery | 1392 | 56 | 55 | Northeast | Pills | Mean | Postop visit | L | |
Bone | 499 | |||||||||
Soft tissue | 893 | |||||||||
Kumar et al. [64] | Shoulder surgery | 62 | 48 | 26 | 0 | Northeast | Pills | Mean | 90 | L |
Maughan et al. [65] | Dental surgery | 72 | 28 | 61 | 0 | Northeast | Pills and MME | Median | 21 | M |
Merrill et al. [66] | Foot and ankle surgery | 132 | 53.2 | 62 | 0 | South | Pills | Mean | 10 | M |
Bone | 91 | |||||||||
Soft tissue | 41 | |||||||||
Miller et al. [67] | Carpal tunnel release | 159 | 59.4 | 56 | 0 | Northeast | Pills | Mean | -- | M |
Osmundson et al. [68] | Cesarean section | 179 | 31 | 100 | South | Pills and MME | Median | 14 | M | |
Osmundson et al. [9] | Cesarean section | 85 | 30 | 100 | South | Pills and MME | Median | 14 | L | |
Patel HD et al. [69] | Radical prostatectomy | 205 | South | MME | Mean | 30 | L | |||
Minimally invasive | 149 | 61.5 | 0 | |||||||
Open | 56 | 61.2 | 0 | |||||||
Patel S et al. [70•] | Rhinoplasty | 62 | Multiple | Pills | Mean | 5 | M | |||
Peters et al. [71] | Carpal tunnel release | 49 | 57 | 66 | 0 | Canada | Pills | Mean | 84 | M |
Riley et al. [72] | Rhinologic surgery | 42 | 48.6 | 33 | 2.4 | Northeast | MME | Median | 14 | M |
Rodgers et al. [73] | Upper extremity surgery | 249 | 54 | 67 | 0 | Midwest | Pills | Mean | 14 | M |
Bone | 58 | |||||||||
Soft tissue | 191 | |||||||||
Sabatino et al. [74] | Orthopedic procedures | 557 | Northeast | Pills | Mean | 14 | M | |||
Total hip arthroplasty | 198 | 65 | 52 | 19 | ||||||
Total knee arthroplasty | 146 | 65.7 | 56 | 17 | ||||||
Carpal tunnel release | 91 | 59.6 | 58 | 15 | ||||||
Rotator cuff repair | 72 | 60.6 | 32 | 17 | ||||||
Lumbar decompression | 50 | 65.6 | 48 | 20 | ||||||
Saini et al. [75•] | Foot and ankle surgery | 988 | 49 | 62 | 0 | Northeast | Pills | Median | 14 | M |
Bone | 754 | |||||||||
Soft tissue | 234 | |||||||||
Schmidt et al. [76] | Cesarean section | 141 | 32 | 100 | Midwest | Pills | Median | 14 | M | |
Solouki et al. [77] | Urogynecologic surgery | 143 | 59.5 | 100 | 12.6 | Northeast | Pills | Mean | 30 | M |
Stepan, et al. [78] | Hand surgery | 54 | 54.9 | 57 | 0 | Midwest | MME | Mean | 7 | L |
Swarup et al. [79] | Anorectal surgery | 23 | 48 | 0 | Northeast | Pills | Median | 14 | M | |
Swenson et al. [80] | Urogynecologic surgery | 50 | 63 | 100 | 20 | Midwest | Pills | Median | 14 | M |
Tan et al. [81] | Abdominal procedures | 176 | 60.4 | 50 | 0 | Midwest | MME | Median | 26 | M |
Minimally invasive | 123 | |||||||||
Open | 53 | |||||||||
Tharakan et al. [82] | Thyroidectomy and parathyroidectomy | 89 | 55 | 82 | Northeast | Pills | Median | 42-730 | M | |
Thiels, et al. [83] | Various surgeries | 2486 | Multiple | MME | Median | 28 | M | |||
Carotid endarterectomy | 73 | 73 | 37 | |||||||
Parathyroidectomy | 108 | 67.5 | 83 | |||||||
Arteriovenous fistula creation | 63 | 68 | 47 | |||||||
MIS partial colectomy with anastomosis | 70 | 62 | 68 | |||||||
Carpel tunnel release | 128 | 65 | 100 | |||||||
Breast lumpectomy | 111 | 65 | 58 | |||||||
MIS cholecystectomy | 138 | 64 | 16 | |||||||
MIS inguinal hernia repair | 107 | 65 | 100 | |||||||
Ovarian cancer cytoreduction | 58 | 62 | 6 | |||||||
Open inguinal hernia repair | 109 | 70 | 97 | |||||||
Simple mastectomy | 76 | 67.5 | 100 | |||||||
MIS hysterectomy; | 139 | 56 | 36 | |||||||
MIS low anterior resection; | 25 | 59 | 0 | |||||||
MIS prostatectomy | 105 | 62 | 39 | |||||||
MIS nephrectomy | 100 | 65 | 47 | |||||||
Knee arthroscopic meniscectomy | 112 | 49 | 45 | |||||||
Open pancreaticoduodenectomy | 40 | 65.5 | ||||||||
MIS lung wedge resection | 110 | 64.5 | 49 | |||||||
Tonsillectomy | 60 | 31 | 70 | |||||||
Rotator cuff surgery | 129 | 61 | 36 | |||||||
Lumbar Laminotomy/laminectomy | 91 | 60 | 32 | |||||||
Open lung lobectomy | 43 | 66 | 49 | |||||||
Lumbar fusion | 75 | 59 | 41 | |||||||
Total hip arthroplasty | 202 | 67 | 48 | |||||||
Total knee arthroplasty | 214 | 69 | 53 | |||||||
Weiland et al. [84•] | Third molar extraction | 48 | 19.6 | 67 | Northeast | Pills | Median | 7 | M | |
Wojahn et al. [85•] | Knee arthroscopy | 221 | 46.2 | 48 | 2.7 | Midwest | Pills | Median | 42 | L |
Risk of bias scores based on MINORS tool [19]. Studies were rated on 8 categories: (1) clearly stated aim, (2) inclusion of consecutive patients, (3) prospective collection of data, (4) endpoints appropriate to aim or study, (5) unbiased assessment of study endpoint, (6) follow-up period appropriate to aim of study, (7) loss to follow-up rate (adapted to < 20% based on typical study endpoints), and (8) prospective calculation of study size. We added a 9th category, assessment methodology to further adapt the instrument for use for this project. Each category received a 0-2 score. On this scale, 0—not reported, 1—reported, but inadequate, and 2—reported and adequate. Thus, each study received a score between 0-18. Risk of bias categories were assigned based on tertiles: high (H), 0-5; moderate (M), 6-12; low (L), 13-18