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Opioid requirements in primary versus revision reverse shoulder arthroplasty

Abstract

Purpose

The purpose of this study is to evaluate the inpatient pain medication use of patients who had a revision shoulder arthroplasty procedure performed and compare them to a cohort of patients who had a primary reverse total shoulder arthroplasty (rTSA) performed to determine whether revision shoulder arthroplasty requires more pain medication..

Methods

A retrospective review was performed on patients undergoing revision arthroplasty (n = 75) and primary rTSA (n = 340). Inpatient medication records were reviewed to tabulate the visual analog pain (VAS) all narcotic medication use, and total morphine equivalent units (MEUs) were calculated for the duration of the inpatient stay.

Results

There was no significant difference between groups regarding age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, preoperative narcotic pain medication use, tobacco use, postoperative VAS scores or hospital length of stay. There were no predictors of total postoperative MEUs identified. Overall, patients in the revision arthroplasty group received significantly less total MEUs than those in the primary rTSA group, 134.96 MEUs vs. 69.79 MEUs, respectively (p < .0005).

Conclusion

The perceived notion that revision shoulder arthroplasty is more painful may cause providers to be more inclined to increase narcotic use, or use more invasive pain control techniques. Based on these data, we found that revision shoulder arthroplasty did not require an increased opioid requirement, longer length of stay or increase VAS, suggesting that these patients can often be managed similarly to primary rTSA.

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The authors did not receive support from any organization for the submitted work.

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Correspondence to B. Gage Griswold.

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Financial interests: Dr. Stephen A. Parada is a consultant and receives institutional research support from Exactech, Inc. (Gainesville, FL) He is a consultant for Arthrex, Inc. Dr. Lynn A. Crosby is a consultant for Exactech, Inc. Nonfinancial interests: Dr. Stephen A. Parada is a committee member for AAOS and ASES.

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Gage Griswold, B., Fielding Callaway, L., Meng, M.R.I. et al. Opioid requirements in primary versus revision reverse shoulder arthroplasty. Eur J Orthop Surg Traumatol (2021). https://doi.org/10.1007/s00590-021-03121-x

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Keywords

  • Practice management
  • Opioids
  • Narcotics
  • Shoulder arthroplasty
  • Pain management