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Updated: Dec 19, 2025
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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
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Perioperative Opioid Use Predicts Postoperative Opioid Use and Inferior Outcomes After Shoulder Arthroscopy
Yining Lu1, Alexander Beletsky2, Matthew R Cohn2
1Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.
Summary
Preoperative opioid use in arthroscopic shoulder surgery patients predicts worse outcomes, including persistent pain and higher revision rates. Patients using opioids before surgery experienced lower satisfaction and continued opioid use post-operation.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Patient Outcomes Research
Background:
- Preoperative opioid use is common in patients undergoing arthroscopic shoulder surgery.
- The impact of this preoperative use on postoperative outcomes remains incompletely understood.
Purpose of the Study:
- To determine the effect of preoperative opioid use on postoperative opioid consumption.
- To evaluate the influence of preoperative opioid use on patient-reported outcomes (PROMs).
- To assess the association between preoperative opioid use and revision surgery rates.
Main Methods:
- Retrospective cohort study of patients undergoing arthroscopic shoulder surgery.
- Inclusion criteria: completion of preoperative and 1-year postoperative PROMs and opioid use questionnaires.
- Matched cohort analysis and multivariate regression to identify predictors of outcomes.
Main Results:
- Preoperative opioid use was associated with significantly worse preoperative and postoperative PROM scores.
- Opioid use predicted reduced patient satisfaction, increased persistent pain, and higher 1-year opioid use.
- High perioperative opioid dosage increased revision surgery risk (OR, 8.59).
Conclusions:
- While patients with preoperative opioid use can improve, they face poorer satisfaction and higher risks.
- Preoperative opioid use is a significant predictor of persistent pain and continued opioid consumption post-surgery.
- Identifying thresholds for perioperative opioid use can predict postoperative consumption.
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