Multimodal analgesia decreases opioid consumption after shoulder arthroplasty: A prospective cohort study

Postoperative pain is the most concerning factor by patients undergoing any surgical procedure. Various multimodal approaches have been shown to regulate postoperative pain and decrease opioid medication use. There is a lack of evidence regarding the use of similar multimodal approach in shoulder arthroplasty. Therefore in the present prospective cohort study, the author demonstrated that multimodal analgesia regimen decreased the postoperative pain and opioid consumption.

Studies on perioperative pain management of shoulder arthroplasty focus on regional anesthesia, with limited analysis of other strategies. Perioperative multimodal analgesia involves reduced opioid consumption and opioid-related adverse events in lower-extremity arthroplasty. This study covered a standard or multimodal analgesia regimen and its comparison with regards to opioid consumption, length of stay, readmission rates, and pain scores among postoperative shoulder arthroplasty patients.

At a single institution, a prospective cohort analysis was conducted. The patients went through elective shoulder arthroplasty were administered with either multimodal analgesia regimen or a standard opioid-based regimen perioperatively. The opioid use, pain scores, 30- and 90-day emergency department visits, length of stay, and readmission rates were considered as the analysis outcome measures.  

A total of 75 patients were selected. Lower postoperative day 0 pain scores, opioid use and length of inpatient stay were noticed with multimodal analgesia regimen as compared to the standard regimen. No difference was seen in the incidence of 30- or 90-day emergency department visits or readmission.

The participants go through shoulder arthroplasty with a multimodal analgesia regimen showed reduced opioid consumption,  hospital stays and postoperative pain. It is an effective and safe regimen for postoperative pain management as no increase in short-term complications, or unplanned readmissions were seen.