Post-discharge opioid utilization patterns in orthopedic patients are underestimated: an explorative study

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Post-operative pain management is crucial after total hip (THA) and knee arthroplasty (TKA).
• Understanding patient opioid consumption patterns is essential for optimizing pain control and minimizing risks.

Purpose of the Study:

• To investigate morphine utilization patterns in patients following THA and TKA.
• To quantify morphine use and identify patient subgroups based on consumption levels.

Main Methods:

• Prospective monitoring of morphine intake for 14 days post-discharge.
• Patients recorded morphine use and pain scores (Visual Analog Scale).
• Morphine use was categorized into non-users, short-term users (<100 MME), and consistent users (>100 MME).

Main Results:

• 63.3% of patients used morphine post-discharge, with a median VAS score of 5.
• Short-term users (n=19) averaged 40 MME, primarily in the first three days.
• Consistent users (n=15) averaged 220 MME, with gradual tapering; only 3% continued use after 14 days.

Conclusions:

• The majority of patients require minimal morphine after THA/TKA.
• Opioid use typically decreases significantly within two weeks post-surgery.
• Further investigation may be warranted for patients with high morphine consumption.