{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T21:31:32Z","timestamp":1773178292680,"version":"3.50.1"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Study objective<\/jats:title>\n                    <jats:p>To evaluate the risk of developing psychiatric disorders within three years after non-cardiac surgery in patients exposed to fentanyl analogs versus other opioids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Postoperative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>The study included 52,640adult patients who underwent non-cardiac surgery at Samsung Medical Center, Seoul, Korea, between January 2011 and June 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Patients were divided into those exposed to fentanyl analogs and those exposed to other opioids. Propensity score matching and Cox regression analysis were used to compare the incidence of psychiatric disorders between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec006\">\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Psychiatric outcomes, including depression, anxiety, stress-related disorders, substance use disorders, and psychotic disorders, were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec007\">\n                    <jats:title>Main results<\/jats:title>\n                    <jats:p>\n                      The study included 52,640 patients, evenly split between the fentanyl and other opioid groups. Fentanyl exposure was associated with a higher incidence of composite psychiatric outcomes (hazard ratio [HR] 1.28 [1.13\u20131.46];\n                      <jats:italic>P\u2009<\/jats:italic>\n                      &lt;\u20090.001), including depression (HR 1.25 [1.08\u20131.45];\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u20090.003) and stress-related disorders (HR 1.45 [1.02\u20132.04];\n                      <jats:italic>P\u2009<\/jats:italic>\n                      =\u20090.036). Subgroup analyses indicated increased risks in males, females, patients without alcohol history, and those not undergoing emergency surgeries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec008\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perioperative fentanyl use is linked to a higher risk of psychiatric disorders compared to other opioids. These findings emphasize the need for careful use and monitoring of fentanyl in surgical patients, considering both immediate and long-term mental health effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0338927","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T18:37:33Z","timestamp":1767206253000},"page":"e0338927","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of perioperative fentanyl analog exposure with risk of psychiatric disorder in non-cardiac surgery: A 10-year retrospective study in a Korean tertiary hospital"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3678-9862","authenticated-orcid":true,"given":"Dong Yun","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ah 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