Day Wesley, Halperin Scott, Surucu Serkan, Jimenez Andrew E, Katsnelson Beatrice, Zhu Justin, Grauer Jonathan N
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut, U.S.A.
Arthrosc Sports Med Rehabil. 2025 Jan 16;7(2):101078. doi: 10.1016/j.asmr.2025.101078. eCollection 2025 Apr.
To analyze postoperative opioid prescriptions after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) in a large, opioid-naive population and to evaluate factors associated with receiving more opioids.
Opioid-naive adult patients who underwent hip arthroscopy for FAIS were queried in the 2010 to 2022 PearlDiver Mariner 161 national administrative database. Exclusion criteria included patients with a history of chronic pain and patients who received opioid prescriptions more than 30 days before surgery. Patient variables were extracted: age, sex, and Elixhauser Comorbidity Index. Ninety-day postoperative opioid prescriptions (by total morphine milligram equivalents [MMEs]) were assessed with multivariate linear regression. Ninety-day postoperative opioid prescriptions from 2011 to 2021 were assessed.
Of 27,079 patients with postoperative opioid prescriptions identified, a mean ± standard deviation of 347.6 ± 729.2 MMEs (40 tablets of 5 mg oxycodone) were prescribed per patient, with a mean of 1.6 prescriptions filled per patient within 90 days following surgery. Seventy-five percent of patients filled fewer than 600 MMEs, but a small subset filled more than 2,000 MMEs. Multivariate analysis revealed that, compared to patients in the age 30- to 39-year group, those aged 20 to 29 years received fewer MMEs (Δ = -72.5, < .017). Compared to those with an Elixhauser Comorbidity Index of 2 or under, those >2 were prescribed more MMEs (Δ = 52.5, < .017). Sex did not correlate with the postoperative MMEs prescribed. From 2011 to 2021, a 58.2% decrease in the 90-day mean MMEs prescribed was noted per patient ( < .017).
Fewer postoperative MMEs were filled following FAIS hip arthroscopy for patients in their 20s relative to those in their 30s, as well as for those with lower comorbidity burden. Patient sex was not associated with differences in postoperative MMEs prescribed. The amount of mean MMEs prescribed per patient decreased from 2011 to 2021.
This study provides information about the typical amount of narcotics required after surgery. This is increasingly useful information, as surgeons/clinicians continue to try to minimize the role of narcotics in postoperative recovery.
分析在大量未使用过阿片类药物的人群中，髋关节镜治疗股骨髋臼撞击综合征（FAIS）后的术后阿片类药物处方情况，并评估与接受更多阿片类药物相关的因素。
在2010年至2022年的PearlDiver Mariner 161国家行政数据库中查询因FAIS接受髋关节镜手术的未使用过阿片类药物的成年患者。排除标准包括有慢性疼痛病史的患者以及术前30天以上接受过阿片类药物处方的患者。提取患者变量：年龄、性别和埃利克斯豪泽合并症指数。采用多变量线性回归评估术后90天的阿片类药物处方（以总吗啡毫克当量[MMEs]计）。评估了2011年至2021年术后90天的阿片类药物处方。
在27079例有术后阿片类药物处方的患者中，每位患者平均开具的MMEs为347.6±729.2（相当于40片5毫克羟考酮），术后90天内每位患者平均开具1.6张处方。75%的患者开具的MMEs少于600，但一小部分患者开具的超过2000 MMEs。多变量分析显示，与30至39岁年龄组的患者相比，20至29岁的患者接受的MMEs较少（差值=-72.5，P<.017）。与埃利克斯豪泽合并症指数为2或以下的患者相比，指数>2的患者开具的MMEs更多（差值=52.5，P<.017）。性别与术后开具的MMEs无关。从2011年到2021年，每位患者术后90天平均开具的MMEs减少了58.2%（P<.017）。
与30多岁的患者相比，20多岁的患者以及合并症负担较低的患者在FAIS髋关节镜检查后填充的术后MMEs较少。患者性别与术后开具的MMEs差异无关。从2011年到2021年，每位患者开具的平均MMEs数量有所下降。
本研究提供了术后所需麻醉药品典型用量的信息。随着外科医生/临床医生继续努力尽量减少麻醉药品在术后恢复中的作用，这一信息越来越有用。
