Preoperative Opioid Use Among Patients Undergoing Shoulder Arthroplasty Predicts Prolonged Postoperative Opioid Use.

Abstract

This study determines the incidence of opioid use before shoulder arthroplasty and analyzes its influence on postoperative use. A retrospective analysis of patients undergoing shoulder arthroplasty with at least 2-year follow-up was performed. Then, at pre- and postoperative appointments, the patients were asked "Do you take narcotic pain medication (codeine or stronger)?" Among 490 patients included in the study, 35.5% reported preoperative opioid use. These patients had higher incidence of opioid use at 1-year follow-up (29.1% versus 4.9%; odds ratio, 8.320; P < 0.001) and at final follow-up (35.1% versus 7.3%; odds ratio, 6.877; P < 0.001). Opioid usage did not change markedly from 1 year follow-up to final follow-up (P > 0.18). Approximately one-third of patients used opioids preoperatively and were seven times more likely to continue opioid use postoperatively. Opioid usage did not change from 1 year follow-up to final follow-up, suggesting that patients still using opioids at their 1-year appointment were likely to continue opioid use. Level III.