Opioid-Free Arthroscopic Rotator Cuff Repair

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Rotator cuff repair often leads to significant postoperative pain, necessitating opioid prescriptions.
• The ongoing opioid epidemic highlights the need for alternative pain control methods in orthopedic surgery.
• Prescription opioids are a known risk factor for opioid abuse and addiction.

Purpose of the Study:

• To assess the effectiveness of an opioid-free postoperative pain protocol for patients undergoing arthroscopic rotator cuff repair.
• To determine if a multimodal, opioid-sparing approach can manage pain adequately after rotator cuff surgery.

Main Methods:

• A prospective study involving 36 patients undergoing arthroscopic rotator cuff repair.
• Implementation of an opioid-free protocol including education, premedication, nerve blockade, and intraoperative injection.
• Discharge with non-opioid medications and a conditional oxycodone prescription for uncontrolled pain.

Main Results:

• 67% of patients successfully completed the procedure without using the opioid prescription.
• Patients who avoided opioids experienced lower overall pain scores throughout the postoperative period.
• Non-opioid users reported higher satisfaction with their pain management at the first postoperative visit.

Conclusions:

• Multimodal pain management strategies can enable a majority of patients to avoid opioids after rotator cuff repair.
• This approach offers a viable alternative to traditional opioid-based pain control in orthopedic surgery.
• Successful opioid-free recovery is achievable with appropriate patient selection and a comprehensive pain management plan.