{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T23:16:16Z","timestamp":1785453376268,"version":"3.56.0"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Patients who have limb amputation are at risk of chronic pain, including phantom limb pain that can be challenging to treat. The aim of this study was to describe the incidence of pre\u2010operative opioid usage and the incidence and risk factors for new persistent post\u2010operative opioid usage in opioid\u2010na\u00efve patients after limb amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study of all patients 18\u00a0years and older underwent upper or lower extremity amputations in Landspitali University Hospital between 2005 and 2015. Patients were considered to use opioids pre\u2010operatively if they filled an opioid prescription 1\u20106\u00a0months prior to amputation and were considered to have persistent opioid use if opioid prescriptions were filled between post\u2010operative months four to twenty\u2010four. In addition to incidence estimate, uni\u2010 and multivariate analysis was performed to identify risk factors for persistent post\u2010operative opioid usage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 328 total patients, 216 (66%) were opioid na\u00efve and 112 (34%) were chronic opioid users. Of the opioid\u2010na\u00efve patients surviving more than 3\u00a0months 40 (20%) developed persistent post\u2010operative opioid usage. In multivariate analysis, factors independently associated with persistent post\u2010operative opioid usage were younger age, male gender, pre\u2010operative use of neuropathic medications or benzodiazepines and lower (opposed to upper) extremity amputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Opioid na\u00efve patients undergoing major amputation had a 20% chance of having a persistent opioid requirement following surgery. This could represent new\u2010onset phantom limb pain or other chronic pain. Our findings should encourage perioperative multimodal efforts to reduce the burden of chronic pain after limb amputations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13497","type":"journal-article","created":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T06:47:10Z","timestamp":1571986030000},"page":"361-367","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The demographics of persistent opioid consumption following limb amputation"],"prefix":"10.1111","volume":"64","author":[{"given":"Talora","family":"Steen","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Brigham and Women's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp B.","family":"Lirk","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Brigham and Women's Hospital Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7054-0844","authenticated-orcid":false,"given":"Martin I.","family":"Sigurdsson","sequence":"additional","affiliation":[{"name":"Division of Anesthesia and Intensive Care Medicine Landspitali\u2010The National University Hospital of Iceland Reykjavik Iceland"},{"name":"Faculty of Medicine University of Iceland Reykjavik Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,11]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"(HCUP) HCaUP.Statistical Brief #223. 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