Skip to content
DraconiticResearch
Search Sources API
197,785 studies31 sourcesUpdated 33 min ago
Peer-reviewedCC BYClinical oral investigations

Postoperative pain outcomes following minor oral surgery in opioid tolerant patients: a retrospective cohort study.

  • Adarsh Gopinath1,2
  • Femi E Ayeni3,4
  • Stephen Cox1,5
5 affiliations
  1. 1Oral Surgery Department, Oral Health Service, Nepean Hospital, Penrith, NSW, Australia.
  2. 2Western NSW Oral Health Service, Dubbo, NSW, Australia.
  3. 3Nepean Institute of Academic Surgery, Nepean Clinical School, The University of Sydney, 62 Derby St., Sydney, Kingwood, NSW, 2747, Australia. [email protected].
  4. 4Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Sydney, NSW, Australia. [email protected].
  5. 5Faculty of Medicine and Health, Sydney Dental School, The University of Sydney, Sydney, NSW, Australia.
Read full textPDFDOICite

Abstract

Background

Evidence guiding postoperative pain management in patients taking prescription or illicit opioids undergoing minor oral surgery is limited. It remains unclear whether standard analgesic protocols for opioid naïve patients provide adequate pain relief in opioid tolerant individuals. This study evaluated whether standard postoperative analgesia achieves adequate pain control in opioid tolerant patients undergoing minor oral surgery with expected mild to moderate pain.Methods

A single centre retrospective study was conducted of patients undergoing minor oral surgical procedures at a public oral surgery service between May 2020 and May 2024. Patients were classified as opioid tolerant if prescribed opioids for longer than one month, receiving methadone therapy, reporting current illicit opioid use, or having a documented history of opioid use disorder. Opioid naïve patients served as controls. Standard postoperative analgesia consisted of paracetamol and non-steroidal anti-inflammatory drugs unless contraindicated. The primary outcome was return with postoperative pain requiring additional opioid analgesia.Results

A total of 1,263 patient records met inclusion criteria, including 184 opioid tolerant and 1,079 opioid naïve patients. Opioid tolerant patients were significantly more likely to return with postoperative pain requiring additional opioid analgesia compared with opioid naïve patients (28.8% vs. 2.2%; adjusted OR 24.59, 95% CI: 13.26-45.62; p < 0.001). This association remained consistent across demographic subgroups and extraction types.Conclusions

Current post operative analgesic pathways may not fully address the analgesic requirements of some opioid exposed patients. This study demonstrates that opioid tolerance is associated with an increased risk of return presentation requiring additional opioid analgesia.Clinical relevance

Opioid tolerance is associated with an increased risk of inadequate postoperative pain control, highlighting the need for tailored analgesia beyond standard regimens.

Related

  1. Reported outcomes for patients following postoperative periprosthetic femoral fractures : a systematic review
    Wenjuan Cong, Emily Howell, Tom Krause +8
    Bone & joint researchPeer-reviewedCC BYFull textSurgery & anaesthesiaEurope PMC
  2. Urban, regional and remote outcomes following TAVR for Queensland patients: a retrospective cohort study
    P. Cameron, A. Brazzale, G. Starmer +1
    medRxivPreprintAll rights reservedFull textCardiovascular medicinemedRxiv
  3. Clinical outcomes following a traditional Chinese medicine foot bath preparation for lower-limb edema and sleep disturbance: a single-center retrospective study of 2,000 patients
    Yehua Zhao, Jingwang Wei, Shanbairong Nie +2
    Frontiers in pharmacologyPeer-reviewedCC BYFull textPharmacology & toxicologyEurope PMC
  4. Risk factors and outcomes of early postoperative complications following congenital heart surgery: a retrospective study at a tertiary care hospital in Nairobi, Kenya.
    Nasra Ismail Adan, James Orwa, Ismail Ahmed +2
    Journal of cardiothoracic surgeryPeer-reviewedCC BYFull textEpidemiology & public healthEurope PMCDOAJ
  5. The impact of preoperative radiological paraspinal lumbar measures on the postoperative satisfaction of patients following lumbar fusion surgery- a retrospective case-control study.
    Lei Wang, Jingming Wang, Xiaoduo Xu +3
    BMC musculoskeletal disordersPeer-reviewedCC BY-NC-NDFull textGeneral medicineEurope PMCPMC

Cite

BibTeXRIS
BibTeX
@article{gopinath2026postoperative,
  title = {{Postoperative pain outcomes following minor oral surgery in opioid tolerant patients: a retrospective cohort study.}},
  author = {Adarsh Gopinath and Femi E Ayeni and Stephen Cox},
  journal = {Clinical oral investigations},
  year = {2026},
  month = oct,
  doi = {10.1007/s00784-026-07229-4},
  url = {https://europepmc.org/article/MED/42905165},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Postoperative pain outcomes following minor oral surgery in opioid tolerant patients: a retrospective cohort study.
AU  - Adarsh Gopinath
AU  - Femi E Ayeni
AU  - Stephen Cox
PY  - 2026
DA  - 2026/10/21
JO  - Clinical oral investigations
DO  - 10.1007/s00784-026-07229-4
UR  - https://europepmc.org/article/MED/42905165
AB  - Background  Evidence guiding postoperative pain management in patients taking prescription or illicit opioids undergoing minor oral surgery is limited. It remains unclear whether standard analgesic protocols for opioid naïve patients provide adequate pain relief in opioid tolerant individuals. This study evaluated whether standard postoperative analgesia achieves adequate pain control in opioid tolerant patients undergoing minor oral surgery with expected mild to moderate pain.Methods  A single centre retrospective study was conducted of patients undergoing minor oral surgical procedures at a public oral surgery service between May 2020 and May 2024. Patients were classified as opioid tolerant if prescribed opioids for longer than one month, receiving methadone therapy, reporting current illicit opioid use, or having a documented history of opioid use disorder. Opioid naïve patients served as controls. Standard postoperative analgesia consisted of paracetamol and non-steroidal anti-inflammatory drugs unless contraindicated. The primary outcome was return with postoperative pain requiring additional opioid analgesia.Results  A total of 1,263 patient records met inclusion criteria, including 184 opioid tolerant and 1,079 opioid naïve patients. Opioid tolerant patients were significantly more likely to return with postoperative pain requiring additional opioid analgesia compared with opioid naïve patients (28.8% vs. 2.2%; adjusted OR 24.59, 95% CI: 13.26-45.62; p < 0.001). This association remained consistent across demographic subgroups and extraction types.Conclusions  Current post operative analgesic pathways may not fully address the analgesic requirements of some opioid exposed patients. This study demonstrates that opioid tolerance is associated with an increased risk of return presentation requiring additional opioid analgesia.Clinical relevance  Opioid tolerance is associated with an increased risk of inadequate postoperative pain control, highlighting the need for tailored analgesia beyond standard regimens.
SN  - 1432-6981
SN  - 1436-3771
ER  -