These authors conducted a prospective cohort analysis of patients undergoing elective shoulder arthroplasty who were treated with either a standard opioid-based regimen or a multimodal analgesia regimen perioperatively.
Collection was performed sequentially: the first 75 patients treated with the standard regimen, followed by 75 patients treated with the multimodal regimen. Patients with high preoperative chronic opioid use (defined as >60 mg of oral morphine equivalents taken daily) and patients with active infection undergoing removal of implants were excluded.
Patients in the standard group received scheduled doses of an opioid and acetaminophen combination medication postoperatively, with additional opioid medications as needed for pain control.
Multimodal patients received scheduled doses of non-opioid analgesics preoperatively and postoperatively, with additional opioid medications as needed for pain control.
Patients treated with the multimodal analgesia regimen had significantly lower postoperative day 0 pain scores (mean, 1.5 vs 2.2; P = .027).
The length of inpatient stay was significantly shorter for multimodal patients than for patients treated with the standard regimen (1.44 days vs 1.91 days, P < .01) as shown below. Parenthetically, this chart demonstrates that the cost of the implant is almost half of the hospital costs.
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