Toxicology Screening Testing in Patients Undergoing Spine Surgery: A Prospective Observational Pilot Study.

Abstract:

BACKGROUND:Chronic opioid use and polypharmacy are commonly seen in chronic pain patients presenting for spine procedures. Substance abuse and misuse have also been reported in this patient population. Negative perioperative effects have been found in patients exposed to chronic opioid, alcohol, and recreational substances. Toxicology screening testing (TST) in the perioperative period provides useful information for adequate preoperative optimization and perioperative planning. METHODS:We designed a pilot study to understand this population's preoperative habits including accuracy of self-report and TST-detected prescribed and unprescribed medications and recreational substances. We compared the results of the TST to the self-reported medications using Spearman correlations. RESULTS:Inconsistencies between TST and self-report were found in 88% of patients. Spearman correlation was 0.509 between polypharmacy and intraoperative propofol use, suggesting that propofol requirement increased as the number of substances used increased. CONCLUSIONS:TST in patients presenting for spine surgery is a useful tool to detect substances taken by patients because self-report is often inaccurate. Discrepancies decrease the opportunity for preoperative optimization and adequate perioperative preparation.

journal_name

Ther Drug Monit

authors

Clavijo CF,Oliva AM,Dingmann C,Kaizer A,Christians U,Burger E,Patel V,Kleck CJ,Vogel SA,Scott BK,Janik DJ,Jameson LC,Ginde AA

doi

10.1097/FTD.0000000000000837

subject

Has Abstract

pub_date

2021-02-01 00:00:00

pages

136-138

issue

1

eissn

0163-4356

issn

1536-3694

pii

00007691-202102000-00015

journal_volume

43

pub_type

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