Outpatient narcotic consumption following total shoulder arthroplasty

Alexander Martusiewicz, Adam Z. Khan, Aaron M. Chamberlain, Jay D. Keener, Alexander W. Aleem

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Introduction: In the setting of the opioid epidemic, physicians continue to scrutinize ways to minimize exposure to narcotic medications. Several studies emphasize improvements in perioperative pain management following total shoulder arthroplasty (TSA). However, there is a paucity of literature describing outpatient narcotic consumption requirements following TSA. Methods: A single-institution, prospective study of patients undergoing primary TSA was performed. Preoperative demographics including exposure to narcotics, smoking history, and alcohol exposure were collected. The primary outcome was measurement of total outpatient narcotic consumption 6 weeks from surgery. Narcotic consumption was verified by counting leftover pills at the final follow-up visit. Results: Overall, 50 patients were enrolled. The median narcotic consumption in the cohort was 193 morphine equivalent units (MEUs), approximately 25 (5-mg) tablets of oxycodone, and the mean consumption was 246 MEUs, approximately 32 (5-mg) tablets. Almost 25% of patients consumed fewer than 10 total tablets, with 10% of patients taking no narcotics at home. Multivariate regression found preoperative narcotic exposure associated with increased consumption of 31 MEUs (P =.004). Older age was found to be protective of narcotic consumption, with increasing age by 1 year associated with 0.75 MEU decrease in consumption (P =.04). Conclusions: Anatomic total shoulder arthroplasty in general provides quick, reliable pain relief and does not require a significant amount of narcotic medication postoperatively. For most patients, it is reasonable to prescribe the equivalent of 25-30 (5-mg) oxycodone tablets following TSA.

Original languageEnglish
Pages (from-to)100-104
Number of pages5
JournalJSES International
Volume4
Issue number1
DOIs
StatePublished - Mar 2020

Keywords

  • Case Series
  • Level IV
  • Shoulder arthroplasty
  • Treatment Study
  • narcotic
  • opioid
  • opioid epidemic
  • outpatient pain management
  • shoulder arthritis

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