Farokhnia Roxana, Garmon Emily H, Allen Bryce C, Fettiplace Michael R, Hofkamp Michael P
Texas A&M College of Medicine, Dallas, Texas, USA.
Department of Anesthesiology, Baylor Scott & White Medical Center - Temple, Temple, Texas, USA.
Proc (Bayl Univ Med Cent). 2025 Apr 28;38(4):442-446. doi: 10.1080/08998280.2025.2494956. eCollection 2025.
The primary aim of our study was to determine which patient and clinical characteristics were associated with opioid consumption in phase I recovery following unilateral total knee arthroplasty (TKA) at our hospital.
Our institutional review board approved this study. A total of 600 Black, Hispanic, and White patients who underwent unilateral TKA at Baylor Scott & White Medical Center - Temple from January 1, 2018 to December 31, 2022 were randomly selected for analysis. Patients were excluded from the final analysis if there was incomplete data regarding opioid consumption or body mass index, if the procedure was improperly coded, or if the patient received liposomal bupivacaine as part of their local infiltration analgesia.
Among the 534 patients included in the final analysis, 373 and 161 patients did and did not receive opioid medication in phase I recovery, respectively. Preoperative acetaminophen administration (adjusted odds ratio [aOR] 2.17; 95% confidence interval [CI] 1.25, 3.78; = 0.006) and general anesthesia as primary anesthetic technique (aOR 3.56; 95% CI 1.55, 8.17; = 0.003) were independently associated with opioid consumption during phase I recovery following TKA.
Patients who received opioid medication in phase I recovery following TKA were more likely to have received preoperative acetaminophen and general anesthesia compared to patients who received no opioid medication.
我们研究的主要目的是确定在我院单侧全膝关节置换术(TKA)后I期康复过程中,哪些患者和临床特征与阿片类药物的使用有关。
我们的机构审查委员会批准了这项研究。从2018年1月1日至2022年12月31日在贝勒斯科特与怀特医疗中心-坦普尔接受单侧TKA的600名黑人、西班牙裔和白人患者中随机选取进行分析。如果关于阿片类药物使用或体重指数的数据不完整、手术编码不当或患者在局部浸润镇痛中接受了脂质体布比卡因,则将患者排除在最终分析之外。
在纳入最终分析的534例患者中,373例和161例患者在I期康复中分别使用和未使用阿片类药物。术前使用对乙酰氨基酚(调整优势比[aOR]2.17;95%置信区间[CI]1.25,3.78;P = 0.006)和全身麻醉作为主要麻醉技术(aOR 3.56;95%CI 1.55,8.17;P = 0.003)与TKA后I期康复期间的阿片类药物使用独立相关。
与未使用阿片类药物的患者相比,TKA后I期康复中使用阿片类药物的患者更有可能接受术前对乙酰氨基酚和全身麻醉。