Opioid-free perioperative pain regimen is ‘safe and effective’ for patients undergoing TSA
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TAMPA, Fla. — Compared with a traditional opioid-containing pain regimen, a multimodal perioperative opioid-free regimen is “safe, effective and predictable” for patients undergoing total shoulder arthroplasty, presented results showed.
“We all know opioids have been a cornerstone for postoperative analgesia use in the United States for the last several decades despite serious side effects, addiction potential and highly questionable efficacy,” Nady Hamid, MD, said in his presentation at the American Shoulder and Elbow Surgeons Annual Meeting. “We’ve seen opioid-free pathways be successful,” he added.
Hamid and colleagues analyzed 35 patients who underwent TSA and received an opioid-free, multimodal perioperative pain management pathway (OF) and 32 patients who underwent TSA and received a traditional opioid-containing perioperative pain management pathway (OC). Outcome measures included the numeric rating scale (NRS) for pain, deviations from the OF pathway, readmissions and opioid-related complications, according to the abstract.
Mean NRS for pain was 0, 1 and 2 at 12 hours, 24 hours and 2 weeks, respectively, for the OF group. In comparison, mean NRS for pain was 3, 4 and 4 at 12 hours, 24 hours and 2 weeks, respectively, for the OC group. Hamid noted mean pain ratings were similar between the cohorts at 6-week follow-up.
In the OF group, one patient required a rescue opioid medication for cervical radiculopathy and one patient took opioid medication that was received from a prior prescription. Among all patients in the OF group, none reported readmission, constipation, falls or delirium.
“Strong consideration can and should be given to utilizing an opioid-free pathway in interested in eligible patients undergoing shoulder arthroplasty,” Hamid said.
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Hamid N, et al. Paper 19. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Dec. 15-17, 2021; Tampa, Fla.
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