Opioid consumption following isolated and recurrent shoulder dislocation and reduction

Area of Science:

• Orthopedic Surgery
• Pain Management
• Public Health

Background:

• Recurrent shoulder dislocations often necessitate multiple medical interventions, increasing opioid exposure.
• This can elevate the risk of chronic opioid use and dependence.
• Understanding opioid patterns in shoulder instability is crucial for patient care.

Purpose of the Study:

• To characterize shoulder instability.
• To compare pre- and postreduction opioid usage between singular dislocators (SDs) and recurrent dislocators (RDs).

Main Methods:

• Retrospective study at a single academic institution.
• Included patients aged 18+ with shoulder dislocations.
• Analyzed electronic medical records for opioid exposure (prescriptions and MME) pre- and postreduction.

Main Results:

• Recurrent dislocators (RDs) were younger and more likely to have prior fractures than singular dislocators (SDs).
• RDs underwent surgery more frequently than SDs.
• RDs showed significantly higher opioid use (prescriptions and MME) at first follow-up, but not at later postoperative visits.

Conclusions:

• Patients with recurrent shoulder dislocations have a higher likelihood of greater opioid consumption post-reduction and surgical intervention.
• Opioid usage patterns may differ in the immediate postreduction period but can normalize over time.
• Counseling patients with chronic shoulder instability on opioid risks is recommended.