Presurgical opioid effects & postsurgical opioid use

Overview of data collection stages pre- and post-surgery

Opioid analgesics are given to millions of people before and after surgery. Postsurgical opioid treatment carries risk of prolonged opioid use, and it is important to understand postsurgical opioid use across countries with varying prescription practices. Opioid analgesic effects are also the subject of strong beliefs, many of which can be described as myths since they do not reflect the state of the scientific evidence (see e.g. Barnett, 2020, NEJM or this talk by Siri Leknes).

In 2018, we started an observation study Kongsberg Hospital where we investigated the acute subjective effects of commonly used opioids (morphine, oxycodone, fentanyl) in an ecological setting: the operating table. We also gathered subjective and prescription data long-term to assess acute and long-term postoperative opioid use in a Norwegian, opioid conservative context.

The project was expanded via grants to Gernot Ernst, Marie Eikemo and Siri Leknes from the Regional Health Authority and Vestre Viken Trust and now encompasses a multi-centre RCT + longitudinal study of predictors of postsurgical opioid use in Norway. The project management team consists of Marie Eikemo, Gernot Ernst, Siri Leknes and Leiv-Arne Rosseland. Kaja Buen is a full-time reseach nurse on the project at Kongsberg, soon to be joined by anaesthetic nurse Siri Gurandsrud Karlsen in a PhD position. Anaesthetists Harald Lenz and Marlin Comelon are new collaborators at OUS together with Leiv Arne Rosseland, and will aid the implementation of the study at Ullevål and other OUS hospitals starting in 2022.

The Surgery Study team at our kickoff meeting at Kongsberg Hospital in May 2021. From left co-PI Siri Leknes, hospital director Stein-Are Agledal, RA Malin Kvande, co-PIs Marie Eikemo & Gernot Ernst, researcher Eira Jensen, postdoc Isabell Meier and specialist nurse Kaja Buen