Session Title: Research Spotlight: Pain and Spine Medicine
Session Time: None. Available on demand.
Disclosures: Terence Hillery, MD: No financial relationships or conflicts of interest
Objective: Clinical practice guidelines support the short term use of muscle relaxant medications for acute low back pain. As focus has sharpened on perioperative outcomes, clinicians have prioritized multimodal pain management and minimization of opiate use. Some surgeons aim to spare opioids by routinely prescribing muscle relaxant drugs to patients after spine surgery. A muscle relaxant, chlorzoxazone, has been studied in the immediate postoperative period, with no significant change in pain level or total opiate use. This study seeks to examine whether muscle relaxant use is associated with a change in total opiate use over the 3-month period following lumbar spine surgery.
Design: A cohort of patients with a history of lumbar spinal surgery were queried from an electronic medical record at an academic medical center. Subjects were grouped into cohorts based on whether the patient was prescribed a muscle relaxant medication during the 3-month study period.Setting : Tertiary care academic medical centerParticipants : 1,218 consecutive patients with a history of lumbar spinal surgery at an academic medical center
Interventions: Retrospective chart review study
Main Outcome Measures: Total oral morphine equivalent dose (OME) for the 3 months following spinal surgery
Results: A total of 1,218 patients were included in the analysis. Eight-hundred and fifty were not prescribed muscle relaxants and the mean OME prescribed was 1,779 OME (IQR 495-2,100) compared to 368 who were prescribed muscle relaxants 2,053 OME (IQR 450-2,543). While the average OME dose prescribed for those who were co-prescribed a muscle relaxant was higher, the difference was not statistically significant different (p=0.58).Conclusions: This study does not support the routine use of muscle relaxants for the purpose of decreasing opiate use in lumbar spine surgery patients.
Level of Evidence: Level III
To cite this abstract in AMA style:Hillery T, Suric V, Nadherny W, Kim CH. Do Muscle Relaxants Decrease Total Opioid Use After Lumbar Spine Surgery? A Retrospective Analysis [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/do-muscle-relaxants-decrease-total-opioid-use-after-lumbar-spine-surgery-a-retrospective-analysis/. Accessed December 3, 2023.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/do-muscle-relaxants-decrease-total-opioid-use-after-lumbar-spine-surgery-a-retrospective-analysis/