Sridharan Mathangi, Samade Richard, J Kopechek Kyle, Roebke Austin J, Goyal Kanu S, L Jones Grant, Y Bishop Julie, Cvetanovich Gregory L
College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Arthrosc Sports Med Rehabil. 2021 May 17;3(3):e707-e713. doi: 10.1016/j.asmr.2021.01.008. eCollection 2021 Jun.
To determine whether differences in total morphine equivalent doses (MEDs) prescribed after arthroscopic rotator cuff repair (RCR) existed because of age younger than or older than 55 years and sex and to characterize potential risk factors for needing an opioid medication refill, visiting a provider other than the surgeon (either in the emergency department or ambulatory settings), and postoperative pain control requiring opioids approximately 6 weeks from the date of surgery.
A retrospective cohort study of 100 patients who underwent arthroscopic RCR between July 1, 2018, to November 30, 2018, in a single institution was performed. Data including demographics, perioperative treatments, and postoperative opioid prescriptions were recorded. Our primary hypotheses were evaluated with the Wilcoxon-Mann-Whitney test. Univariate and multivariate analyses assessed potential risk factors for the 3 outcomes of interest. Results were given in adjusted odds ratios (aORs), 95% confidence intervals (CIs), and values.
There was a difference ( = .038) in total MEDs used (in 5 mg oxycodone tablets) between males (median 56 tablets; interquartile range, 50-98 tablets) and females (median 78 tablets; interquartile range, 56-116 tablets). Age younger than 55 years was a risk factor for seeking an opioid refill (OR = 2.51; CI, 1.11-5.66; = .026). A significant risk factor for visiting another provider was preoperative opiate use (OR = 15.0; CI, 1.79-125.8; = .013). Age younger than than 55 years (aOR = 2.51; CI, 1.01-6.02; = .047), body mass index (aOR = 1.08; CI, 1.01-1.17; = .046), and shorter surgical duration (aOR = 0.97; CI, 0.95-0.99, =.007) were independent predictive factors for requiring opioids for pain control 6 weeks after surgery.
After arthroscopic RCR, MED prescription is higher for females than males. The risk factors for requesting opioid prescription refill for pain control 6 weeks after surgery were age younger than 55 years and shorter surgical duration.
Level III, retrospective comparative study.
确定年龄小于或大于55岁以及性别差异是否会导致关节镜下肩袖修复术（RCR）后所开具的吗啡总等效剂量（MED）有所不同，并确定需要补充阿片类药物、前往外科医生以外的其他医疗机构（急诊科或门诊）就诊以及术后约6周需要使用阿片类药物控制疼痛的潜在风险因素。
对2018年7月1日至2018年11月30日在单一机构接受关节镜下RCR的100例患者进行回顾性队列研究。记录包括人口统计学、围手术期治疗及术后阿片类药物处方等数据。我们的主要假设通过Wilcoxon-Mann-Whitney检验进行评估。单因素和多因素分析评估了3个感兴趣结局的潜在风险因素。结果以校正比值比（aOR）、95%置信区间（CI）和P值表示。
男性（中位数56片；四分位间距，50 - 98片）和女性（中位数78片；四分位间距，56 - 116片）使用的吗啡总等效剂量（以5毫克羟考酮片计）存在差异（P = 0.038）。年龄小于55岁是寻求补充阿片类药物的风险因素（OR = 2.51；CI，1.11 - 5.66；P = 0.026）。术前使用阿片类药物是前往其他医疗机构就诊的显著风险因素（OR = 15.0；CI，1.79 - 125.8；P = 0.013）。年龄小于55岁（aOR = 2.51；CI，1.01 - 6.02；P = 0.047）、体重指数（aOR = 1.08；CI，1.01 - 1.17；P = 0.046）以及手术时间较短（aOR = 0.97；CI，0.95 - 0.99；P = 0.007）是术后6周需要使用阿片类药物控制疼痛的独立预测因素。
关节镜下RCR术后，女性的MED处方量高于男性。术后6周因疼痛控制而需要补充阿片类药物处方的风险因素为年龄小于55岁和手术时间较短。
III级，回顾性比较研究。
Zotero 插件