The perioperative effects of chronic preoperative opioid use on shoulder arthroplasty outcomes

Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. A retrospective analysis of patients undergoing elective anatomic total shoulder ar...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2017-11, Vol.26 (11), p.1908-1914
Main Authors: Cheah, Jonathan W., Sing, David C., McLaughlin, Dell, Feeley, Brian T., Ma, C. Benjamin, Zhang, Alan L.
Format: Article
Language:English
Subjects:
Aged
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - therapeutic use
Arthroplasty, Replacement, Shoulder - adverse effects
Arthroplasty, Replacement, Shoulder - methods
chronic pain
complications
Elective Surgical Procedures - adverse effects
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
opioid dependence
opioid use
Osteoarthritis - complications
Osteoarthritis - surgery
Pain Measurement
Pain, Postoperative - drug therapy
Pain, Postoperative - etiology
Patient Readmission
perioperative outcomes
Preoperative Period
Retrospective Studies
reverse total shoulder arthroplasty
Shoulder Joint - surgery
Shoulder Pain - drug therapy
Shoulder Pain - etiology
Total shoulder arthroplasty
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Summary:Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed. We identified 262 patients (170 rTSA and 92 anatomic TSA), of whom 138 were using opioids preoperatively (82% short acting and 18% long acting). When non-opioid users, short-acting opioid users, and long-acting opioid users were compared, mean total milligrams of morphine equivalents administered during postoperative hospitalization was significantly higher for those with preoperative opioid use (66.9 mg, 111.4 mg, and 208.3 mg, respectively; P 
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2017.05.016