167: Long-term opioid use after surgery in Denmark: a nationwide register-based cohort study

Topic: Clinical Science
Subtopic:

Background and Aims: Postoperative opioid use may contribute to long-term exposure and opioid-related harm, yet population-level trajectories following surgical procedures remain insufficiently characterized. This study describes postoperative opioid use patterns across the ten most frequent non-cancer surgical procedures in Denmark and examines the association between preoperative opioid use and long-term postoperative opioid use.

Methods: This nationwide register-based cohort study included 309,486 adults undergoing one of the ten most frequent non-cancer surgical procedure groups in Denmark in 2018. Opioid use was assessed based on redeemed opioid prescriptions (ATC N02A/R05DA04) during the 180-day preoperative period and throughout the first postoperative year. Long-term postoperative opioid use was defined as redemption in all four postoperative quarters. Preoperative opioid use was categorized as none, redemption in one of the two preoperative quarters, or redemption in both quarters. Logistic regression estimated adjusted odds ratios for long-term postoperative opioid use.

Results: Preoperative opioid use prevalence ranged from 4.6% to 22.6% across surgical groups. Long-term postoperative opioid use occurred in 0.1%–0.9% of preoperative non-opioid users compared with 27.1%–38.6% of preoperative opioid users. Opioid redemption peaked in the first postoperative quarter and declined for seven of ten surgical groups, whereas eye and eye area, ear–nose–larynx, and female genitalia surgeries showed persistent use. Preoperative opioid use in either or both preoperative quarters was associated with substantially higher odds of long-term postoperative opioid use, with adjusted odds ratios ranging from 33.9 (95%CI: 30.91-37.27) to 467.3 (95%CI: 235.90-925.64).

Conclusions: Postoperative opioid use generally declines over the first postoperative year but persists in selected surgical groups. Preoperative opioid use is a strong predictor of long-term postoperative opioid use across surgical procedures. Identifying patients with preoperative opioid use may support risk stratification and inform perioperative strategies to reduce prolonged postoperative opioid use.

References: -

Presenting Author: Geana Paula Kurita
Submitting Author: Mark Puch Oernskov

Senior Author: Geana Paula Kurita

IASP 2026 Global Year theme of Neuropathic Pain: No

• Mark Puch Oernskov - Department of Anaesthesiology, Pain and Respiratory Support, Neuroscience Centre, Rigshospitalet - Copenhagen University Hospital, Denmark.
• Ola Ekholm - National Institute of Public Health, University of Southern Denmark, Denmark.
• Suzanne Forsyth Herling - Department of Neuroanesthesiology, Neuroscience Centre, Rigshospitalet - Copenhagen University Hospital, Denmark.
• Per Sjøgren - St. Luke's Academy of Palliative Medicine, St. Lukes Foundation, Hellerup, Denmark.
• Svetlana Ondrasova Skurtveit - Department of Chronic Diseases, The Norwegian Institute of Public Health, Oslo, Norway.
• Ingvild Odsbu - Department of Chronic Diseases, The Norwegian Institute of Public Health, Oslo, Norway.
• Kim Wildgaard - Copenhagen University Hospital Herlev-Gentofte, Department of Anaesthesiology and Herlev Anaesthesia Critical and Emergency Care Science Unit, Denmark.
• Geana Paula Kurita - Department of Anaesthesiology, Pain and Respiratory Support, Neuroscience Centre, Rigshospitalet - Copenhagen University Hospital, Denmark.