Related Experiment Video
Updated: Dec 11, 2025
04:57
Author Spotlight: Minimally Invasive Ultrasound-Guided Acupotomy in Knee Osteoarthritis Treatment
Published on: April 26, 2024
1.0K
Opioid Use and Total Joint Replacement
Cade Shadbolt1, Chris Schilling1, Maria C Inacio2,3
1Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
Current Rheumatology Reports
|August 19, 2020
Summary
Preoperative opioid use in total joint replacement patients is linked to increased infection, revision, and complications. Further research is needed to understand and mitigate these risks for better surgical outcomes.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Pharmacology
Background:
- Preoperative opioid use is common in patients undergoing total joint replacement (TJR).
- The impact of preoperative opioid use on TJR outcomes requires further investigation.
Purpose of the Study:
- To review recent research on the association between preoperative opioid use and outcomes following total joint replacement.
- To identify risks and potential mechanisms linking opioid use to adverse surgical outcomes.
Main Methods:
- Systematic review of current literature.
- Analysis of patient data regarding opioid use and surgical outcomes.
Main Results:
- Preoperative opioid use correlates with higher infection rates, revision surgeries, and short-term complications.
- Patients using opioids pre-surgery show less improvement in pain and function post-surgery.
- Chronic opioid users face particularly pronounced risks.
Conclusions:
- Opioid use may directly impact TJR outcomes via mechanisms like opioid-induced hyperalgesia and immunosuppression.
- More high-quality clinical trials are essential to evaluate interventions for this high-risk group.
- Observational studies are needed to elucidate the mechanisms behind these adverse outcomes.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
768
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
768
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
661
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
661
01:25Analgesia and Pain Management
1.3K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.3K
01:22Opioid Receptors: Overview
3.5K
Opioid receptors, including the mu (μ, MOR), delta (δ, DOR), and kappa (κ, KOR) types, belong to the rhodopsin family of G protein-coupled receptors. These receptors are located throughout the central and peripheral nervous systems and in non-neuronal tissues such as macrophages and astrocytes. Opioid receptor ligands can be categorized into agonists or antagonists. Highly selective agonists include [d-Ala2, MePhe4, Gly(ol)5]-enkephalin or DAMGO for MOR, [D-Pen2,...
3.5K
01:17Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
507
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
507
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
615
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
615