Categories
Change Password!
Reset Password!
The study authors recognized the risk factors associated with the increased use of opioids and other analgesics a year after surgery and concentrated on the comorbidities and surgery-related factors.
Prolonged pain after hip or knee surgery cause increased
use of analgesics. As observed from this single- centre analysis- obesity,
higher age, female gender, number of comorbidities, use of analgesics
preoperatively, and patients with unilateral knee replacement had a higher
probability of using analgesic drugs 1 year after surgery.
The study authors recognized the risk factors associated
with the increased use of opioids and other analgesics a year after surgery and
concentrated on the comorbidities and surgery-related factors.
All patients who underwent a primary hip (6238 patients)
or knee (7501 patients) replacement surgery for osteoarthritis from the year
2002 - 2013 were included. The nationwide Drug Prescription Register was used
to redeem prescriptions for acetaminophen, non-steroidal anti-inflammatory
drugs (NSAIDs), and opioids (mild and strong). One year post-joint replacement,
the rate of analgesic consumption and the adjusted risks ratios for analgesic
use were assessed.
It was found that 3591 (26.1%) patients were still using
analgesics 1 year following the surgery. Generally, the notable predictors of
overall analgesic use were (risk ratio (95% CI)) age 65–74.9 years (reference
< 65); age > 75 years; female gender; body mass index (BMI) 30–34.9 kg/m2
(reference < 25 kg/m2); BMI > 35 kg/m2; and a higher number of
comorbidities (as per the altered Charlson Comorbidity Index score). Considering
the clinical factors, the preoperative analgesic usage was found to be 2.6
(2.5–2.8), and for knee surgery was 1.2 (1.1–1.3), anticipated the use of
analgesics, however immediate bilateral knee replacement (compared to
unilateral procedure) was a protective factor with a value of 0.86 (0.77–0.96).
Opioid use was found to be associated with obesity, greater CCI score,
epilepsy, knee versus hip surgery, unilateral versus bilateral knee operation,
total versus unicompartmental knee replacement, and use of analgesics/opioids
preoperatively.
The closest predictors of increased use of analgesics postoperatively
were obesity (BMI higher tha 35 kg/m2) and preoperative use of
analgesics. Moreover, despite more chances of adverse effect exposure to the
older age and a high number of comorbidities these were found to be associated
with higher analgesic use postoperatively.
Arthrtis Research & Therapy
Predictors of the use of analgesic drugs 1 year after joint replacement: a single-center analysis of 13,000 hip and knee replacements
Tuomas Jaakko Rajamäki et al.
Comments (0)