These authors sought to determine factors influencing inpatient opioid utilization after 622 elective total shoulder arthroplasties (TSA) by 20 different surgeons
The average opioid dose per encounter was 47.4 ± 65.7 morphine milligram equivalents (MMEs) per day.
Pre-existing psychiatric disorders, preoperative opioid use, highest quartile of median household income, current-smoker status, and age < 60 years were associated with increased inpatient opioid consumption after TSA. Expectedly, the 7 patients not having regional anesthesia had higher inpatient opioid consumption.
Sex, race, American Society of Anesthesiologists status, replacement type (anatomic TSA vs. reverse TSA), and prior shoulder surgery did not show any significant differences.
Comment: This study is useful in identifying patients who not only may require more inpatient narcotics, but who may also have greater problems with pain management after hospital discharge. We are less likely to offer elective surgery to patients who are at heightened risk for needing prolonged postoperative narcotics. If surgery is considered for these individuals, a robust in hospital and post discharge pain management plan needs to be in place.
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To see a YouTube of our technique for total shoulder arthroplasty, click on this link.
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To see a YouTube of our technique for total shoulder arthroplasty, click on this link.
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We have a new set of shoulder youtubes about the shoulder, check them out at this link.
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