Anesthesiology

About 7% of opioid‑naïve surgical patients develop new persistent opioid use

This meta‑analysis of 43 observational US studies (n=6,507,173) estimated pooled new persistent opioid use (NPOU) of 7.15% after surgery. Estimates varied by NPOU definition: 8.29% for 90–180 day definitions versus 2.89% with a stricter 180‑day requirement. Heterogeneity was very high (I2=100%) and study quality varied, limiting precise incidence estimates. Authors conclude NPOU is common but variable, and strategies to reduce postoperative opioid exposure are needed. 1

Reviews often mix RCTs and nonrandomized studies of harms without design‑aware methods

This meta‑epidemiological study evaluated 195 systematic reviews that combined RCTs and NRSIs for the same harms outcome. Among 91 reviews that pooled designs, 72.5% included NRSIs at moderate or high risk of bias and 53.8% omitted subgroup analyses by study design. When RCTs and NRSIs were analyzed separately, 67.6% showed qualitative disagreement, and 20% of reviews drew inappropriate conclusions. The authors warn that uncritical pooling risks biased harm estimates and recommend design‑aware synthesis methods. 2

ICU nurses’ pressure‑injury prevention depends on capability, opportunity, and motivation

This qualitative meta‑synthesis pooled 12 studies producing 52 findings organized into 13 categories under two synthesized themes. Prevention behavior was shaped by nurses' knowledge, skills, resources, beliefs, and motivation, indicating multifactorial determinants. Authors recommend coordinated, multi‑component interventions targeting education, environmental resources, and motivational factors. 3