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. 2020 Jun 11;9:139. doi: 10.1186/s13643-020-01393-8

Table 1.

Studies included in meta-analysis

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