B Gage Griswold1, L Fielding Callaway2, Matthew R I Meng3, Cameron S Murphy2, Daniel W Paré4, Jessica Amero4, Michael J Steflik2, Frank D Lewis4, Lynn A Crosby5, Stephen A Parada2. 1. Department of Orthopaedic Surgery, BA-3300, Augusta University Medical Center, 1120 15th Street, Augusta, GA, 30912, USA. bgriswold@augusta.edu. 2. Department of Orthopaedic Surgery, BA-3300, Augusta University Medical Center, 1120 15th Street, Augusta, GA, 30912, USA. 3. Department of Orthopaedic Surgery, RAF Lakenheath Medical Hospital, Brandon, UK. 4. Medical College of Georgia, Augusta University, Augusta, GA, USA. 5. Department of Orthopaedic Surgery, VA Medical Center, University of Nebraska, Omaha, NE, USA.
Abstract
PURPOSE: The purpose of this study is to evaluate the inpatient pain medication use of patients who had a revision shoulder arthroplasty procedure performed and compare them to a cohort of patients who had a primary reverse total shoulder arthroplasty (rTSA) performed to determine whether revision shoulder arthroplasty requires more pain medication.. METHODS: A retrospective review was performed on patients undergoing revision arthroplasty (n = 75) and primary rTSA (n = 340). Inpatient medication records were reviewed to tabulate the visual analog pain (VAS) all narcotic medication use, and total morphine equivalent units (MEUs) were calculated for the duration of the inpatient stay. RESULTS: There was no significant difference between groups regarding age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, preoperative narcotic pain medication use, tobacco use, postoperative VAS scores or hospital length of stay. There were no predictors of total postoperative MEUs identified. Overall, patients in the revision arthroplasty group received significantly less total MEUs than those in the primary rTSA group, 134.96 MEUs vs. 69.79 MEUs, respectively (p < .0005). CONCLUSION: The perceived notion that revision shoulder arthroplasty is more painful may cause providers to be more inclined to increase narcotic use, or use more invasive pain control techniques. Based on these data, we found that revision shoulder arthroplasty did not require an increased opioid requirement, longer length of stay or increase VAS, suggesting that these patients can often be managed similarly to primary rTSA.
PURPOSE: The purpose of this study is to evaluate the inpatient pain medication use of patients who had a revision shoulder arthroplasty procedure performed and compare them to a cohort of patients who had a primary reverse total shoulder arthroplasty (rTSA) performed to determine whether revision shoulder arthroplasty requires more pain medication.. METHODS: A retrospective review was performed on patients undergoing revision arthroplasty (n = 75) and primary rTSA (n = 340). Inpatient medication records were reviewed to tabulate the visual analog pain (VAS) all narcotic medication use, and total morphine equivalent units (MEUs) were calculated for the duration of the inpatient stay. RESULTS: There was no significant difference between groups regarding age, sex, body mass index, Charlson Comorbidity Index, American Society of Anesthesiologists score, preoperative narcotic pain medication use, tobacco use, postoperative VAS scores or hospital length of stay. There were no predictors of total postoperative MEUs identified. Overall, patients in the revision arthroplasty group received significantly less total MEUs than those in the primary rTSA group, 134.96 MEUs vs. 69.79 MEUs, respectively (p < .0005). CONCLUSION: The perceived notion that revision shoulder arthroplasty is more painful may cause providers to be more inclined to increase narcotic use, or use more invasive pain control techniques. Based on these data, we found that revision shoulder arthroplasty did not require an increased opioid requirement, longer length of stay or increase VAS, suggesting that these patients can often be managed similarly to primary rTSA.
Authors: Pia Jæger; Zbigniew J Koscielniak-Nielsen; Henrik M Schrøder; Ole Mathiesen; Maria H Henningsen; Jørgen Lund; Morten T Jenstrup; Jørgen B Dahl Journal: PLoS One Date: 2014-11-11 Impact factor: 3.240
Authors: Jenni N E Harjula; Juha Paloneva; Jaason Haapakoski; Juha Kukkonen; Ville Äärimaa Journal: BMC Musculoskelet Disord Date: 2018-07-21 Impact factor: 2.362