Variation in perioperative opioid use after total joint arthroplasty

doi:10.1016/j.jor.2021.05.003

. 2021 May 7:25:162-166.

doi: 10.1016/j.jor.2021.05.003. eCollection 2021 May-Jun.

Variation in perioperative opioid use after total joint arthroplasty

Charles S Schumacher¹, Mariano E Menendez², Nicholas R Pagani², Andrew A Freiberg³, Young-Min Kwon¹, Hany Bedair¹, David Ring⁴, Harry E Rubash¹

Affiliations

¹ Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Department of Orthopaedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
³ Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, MA, USA.
⁴ Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX, USA.

PMID: 34025059
PMCID: PMC8131953
DOI: 10.1016/j.jor.2021.05.003

Variation in perioperative opioid use after total joint arthroplasty

Charles S Schumacher et al. J Orthop. 2021.

. 2021 May 7:25:162-166.

doi: 10.1016/j.jor.2021.05.003. eCollection 2021 May-Jun.

Authors

Charles S Schumacher¹, Mariano E Menendez², Nicholas R Pagani², Andrew A Freiberg³, Young-Min Kwon¹, Hany Bedair¹, David Ring⁴, Harry E Rubash¹

Affiliations

¹ Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Department of Orthopaedic Surgery, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
³ Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Newton, MA, USA.
⁴ Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, Austin, TX, USA.

PMID: 34025059
PMCID: PMC8131953
DOI: 10.1016/j.jor.2021.05.003

Abstract

Objective: We studied variation in perioperative opioid use after total joint arthroplasty with respect to patient and procedure characteristics in order to inform initiatives to optimize pain relief.

Methods: We recorded perioperative opioid consumption for a cohort of total joint arthroplasty patients to identify factors underlying variation in perioperative opioid use.

Results: Younger patient age, tobacco use, greater symptoms of depression, private insurance, and knee arthroplasty were associated with increased opioid consumption.

Conclusions: Awareness of the patient characteristics associated with increased perioperative opioid use can help inform implementation of targeted strategies for safe, optimal pain relief and satisfaction.

Keywords: Opioid; Pain; Total hip arthroplasty; Total joint arthroplasty; Total knee arthroplasty.

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Conflict of interest statement

•CSS certifies that he had nothing of value related to this study.•MEM certifies that he had nothing of value related to this study.•NRP certifies that he had nothing of value related to this study.•AAF certifies that he had nothing of value related to this study.•YMK certifies that he had nothing of value related to this study.•HB certifies that he had nothing of value related to this study.•DR certified that he had nothing of value related to this study.•HR certifies that he had nothing of value related to this study.

Figures

**Fig. 1**
Correlation of patient age with perioperative opioid consumption.

**Fig. 2**
Association of Symptoms of Depression (PHQ-2 score) with Perioperative Opioid Consumption.

See this image and copyright information in PMC

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References

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1. Dart R.C., Surratt H.L., Cicero T.J. Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med. 2015;372:241–248. doi: 10.1056/NEJMsa1406143. - DOI - PubMed
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1. Pletcher M.J., Kertesz S.G., Kohn M.A., Gonzales R. Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. J Am Med Assoc. 2008;299:70–78. doi: 10.1001/jama.2007.64. - DOI - PubMed
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[1] Cicero T.J., Ellis M.S., Harney J. Shifting patterns of prescription opioid and heroin abuse in the United States. N Engl J Med. 2015;373:1789–1790. doi: 10.1056/NEJMc1505541. - DOI - PubMed

[2] Cicero T.J., Ellis M.S., Harney J. Shifting patterns of prescription opioid and heroin abuse in the United States. N Engl J Med. 2015;373:1789–1790. doi: 10.1056/NEJMc1505541. - DOI - PubMed

[3] Dart R.C., Surratt H.L., Cicero T.J. Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med. 2015;372:241–248. doi: 10.1056/NEJMsa1406143. - DOI - PubMed

[4] Dart R.C., Surratt H.L., Cicero T.J. Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med. 2015;372:241–248. doi: 10.1056/NEJMsa1406143. - DOI - PubMed

[5] Manchikanti L., Helm S 2nd, Fellows B. Opioid epidemic in the United States. Pain Physician. 2012;15:ES9–38. - PubMed

[6] Manchikanti L., Helm S 2nd, Fellows B. Opioid epidemic in the United States. Pain Physician. 2012;15:ES9–38. - PubMed

[7] Pletcher M.J., Kertesz S.G., Kohn M.A., Gonzales R. Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. J Am Med Assoc. 2008;299:70–78. doi: 10.1001/jama.2007.64. - DOI - PubMed

[8] Pletcher M.J., Kertesz S.G., Kohn M.A., Gonzales R. Trends in opioid prescribing by race/ethnicity for patients seeking care in US emergency departments. J Am Med Assoc. 2008;299:70–78. doi: 10.1001/jama.2007.64. - DOI - PubMed

[9] Jones C.M., Mack K.A., Paulozzi L.J. Pharmaceutical overdose deaths, United States, 2010. J Am Med Assoc. 2013;309:657–659. doi: 10.1001/jama.2013.272. - DOI - PubMed

[10] Jones C.M., Mack K.A., Paulozzi L.J. Pharmaceutical overdose deaths, United States, 2010. J Am Med Assoc. 2013;309:657–659. doi: 10.1001/jama.2013.272. - DOI - PubMed

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Variation in perioperative opioid use after total joint arthroplasty

Affiliations

Variation in perioperative opioid use after total joint arthroplasty

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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References

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