Patel Mansi, Young Shing Darren, George Annie, Bhaskaran Dhivya, Atalian Anthony, Walia Manpreet, Patel Milin, Tushinski Daniel, Adili Anthony, Bali Kamal, Khanna Vickas, Sprague Sheila, Madden Kim, Busse Jason W
Division of Orthopedics, McMaster University, Hamilton, CAN.
Faculty of Medicine, University of Ottawa, Ottawa, CAN.
Cureus. 2025 May 12;17(5):e83977. doi: 10.7759/cureus.83977. eCollection 2025 May.
Background and objective Opioid analgesics are routinely prescribed to manage pain after total joint arthroplasty (TJA) but are associated with several adverse effects. There is a scarcity of literature exploring patients' receptivity, attitudes, and perceptions towards opioid-sparing postoperative protocols. In light of this, we conducted this study to address those gaps in the literature. Methods We administered a cross-sectional survey to patients aged 18 years or older who were attending either a preoperative or a postoperative TJA appointment, up to 12 months after surgery. We aimed to determine the proportion of patients who would be open to receiving opioid-free or opioid-reduced postoperative care, identify patient characteristics associated with receptivity, and determine patients' perceptions regarding the efficacy and safety of opioids. We constructed multivariable logistic regression models to explore features associated with patients' receptivity to opioid reduction or avoidance. Results We approached 200 patients, and 190 returned a complete survey. A quarter of respondents believed that other analgesics were similarly effective or superior to opioids, and 68% perceived that opioids were associated with more side effects than alternatives. Of note, 50% of patients indicated that they would be receptive to reduced opioid use postoperatively. Patients' receptivity was associated with not using opioids at the time of survey completion [odds ratio (OR): 2.5, 95% confidence interval (CI): 1.04-6.4), and the belief that opioids had more side effects than alternatives (OR: 3.4, 95% CI: 1.5-7.9); 40% of respondents indicated they would be willing to avoid opioid use after surgery, and receptivity was associated with the belief that opioids cause more side effects than alternatives (OR: 4.3, 95% CI: 1.8-11.9) and that non-opioid analgesics are similarly or more effective (OR: 3.4, 95% CI: 1.4-8.3). Conclusions Many participants were willing to reduce or avoid the use of postoperative opioids, and receptivity was strongly associated with beliefs regarding the comparative benefits and harms of alternatives. These findings suggest opportunities to reduce the use of opioids after TJA and enhance patient education to address misconceptions.
阿片类镇痛药常用于全关节置换术（TJA）后疼痛的管理，但会带来多种不良反应。目前缺乏关于患者对减少阿片类药物术后方案的接受度、态度和认知的文献。鉴于此，我们开展了本研究以填补文献中的这些空白。方法：我们对年龄在18岁及以上、正在接受术前或术后TJA预约（手术时间最长为术后12个月）的患者进行了横断面调查。我们旨在确定愿意接受无阿片类药物或减少阿片类药物术后护理的患者比例，识别与接受度相关的患者特征，并确定患者对阿片类药物疗效和安全性的认知。我们构建了多变量逻辑回归模型，以探索与患者减少或避免使用阿片类药物的接受度相关的特征。结果：我们联系了200名患者，190名患者完成了完整的调查。四分之一的受访者认为其他镇痛药同样有效或优于阿片类药物，68%的受访者认为阿片类药物比其他药物副作用更多。值得注意的是，50%的患者表示他们愿意接受术后减少阿片类药物的使用。患者的接受度与在完成调查时未使用阿片类药物有关[比值比（OR）：2.5，95%置信区间（CI）：1.04 - 6.4]，以及认为阿片类药物比其他药物副作用更多（OR：3.4，95% CI：1.5 - 7.9）；40%的受访者表示他们愿意在术后避免使用阿片类药物，接受度与认为阿片类药物比其他药物副作用更多（OR：4.3，95% CI：1.8 - 11.9）以及非阿片类镇痛药同样有效或更有效（OR：3.4，95% CI：1.4 - 8.3）有关。结论：许多参与者愿意减少或避免使用术后阿片类药物，接受度与对其他药物相对益处和危害的认知密切相关。这些发现表明有机会减少TJA术后阿片类药物的使用，并加强患者教育以消除误解。
