The Association between General Anesthesia and New Postoperative Uses of Sedative–Hypnotics: A Nationwide Matched Cohort Study

Chen Yu Tai, Hsin Yi Liu, Juan P. Cata, Ying Xiu Dai, Mu Hong Chen, Jui Tai Chen, Tzeng Ji Chen, Hsiang Ling Wu, Yih Giun Cherng, Chun Cheng Li, Chien Wun Wang, Ying Hsuan Tai

研究成果: 雜誌貢獻文章同行評審

摘要

Sedative–hypnotic misuse is associated with psychiatric diseases and overdose deaths. It remains uncertain whether types of anesthesia affect the occurrence of new postoperative uses of sedative–hypnotics (NPUSH). We used reimbursement claims data of Taiwan’s National Health Insurance and conducted propensity score matching to compare the risk of NPUSH between general and neuraxial anesthesia among surgical patients who had no prescription of oral sedative–hypnotics or diagnosis of sleep disorders within the 12 months before surgery. The primary outcome was NPUSH within 180 days after surgery. Multivariable logistic regression models were used to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI). A total of 92,222 patients were evaluated after matching. Among them, 15,016 (16.3%) had NPUSH, and 2183 (4.7%) were made a concomitant diagnosis of sleep disorders. General anesthesia was significantly associated both with NPUSH (aOR: 1.17, 95% CI: 1.13–1.22, p < 0.0001) and NPUSH with sleep disorders (aOR: 1.11, 95% CI: 1.02–1.21, p = 0.0212) compared with neuraxial anesthesia. General anesthesia was also linked to NPUSH that occurred 90–180 days after surgery (aOR: 1.12, 95% CI: 1.06–1.19, p = 0.0002). Other risk factors for NPUSH were older age, female, lower insurance premium, orthopedic surgery, specific coexisting diseases (e.g., anxiety disorder), concurrent medications (e.g., systemic steroids), postoperative complications, perioperative blood transfusions, and admission to an intensive care unit. Patients undergoing general anesthesia had an increased risk of NPUSH compared with neuraxial anesthesia. This finding may provide an implication in risk stratification and prevention for sedative–hypnotic dependence after surgery.

原文英語
文章編號3360
期刊Journal of Clinical Medicine
11
發行號12
DOIs
出版狀態已發佈 - 6月 1 2022

ASJC Scopus subject areas

  • 醫藥 (全部)

指紋

深入研究「The Association between General Anesthesia and New Postoperative Uses of Sedative–Hypnotics: A Nationwide Matched Cohort Study」主題。共同形成了獨特的指紋。

引用此