自我报告的大麻使用与髋关节和膝关节置换术后麻醉处方增加有关。
Self-Reported Marijuana Use Is Associated With Increased Narcotic Prescribing Following Hip and Knee Arthroplasty.
作者信息
Block Andrew, Silver Jacob, Pavano Colin, Bellas Nicholas, Zeng Francine, Jaremko Maks, Solovyova Olga
机构信息
UCONN Health, Farmington, Connecticut, USA.
New York University School of Medicine, New York, New York, USA.
出版信息
Iowa Orthop J. 2025;45(1):81-85.
BACKGROUND
Opioid-related deaths continue to rise annually in the United States, prompting a search for alternative or adjunct pain management strategies. Concurrently, marijuana has become increasingly legal, widely used, and culturally accepted. Within orthopedic surgery, there is growing interest in exploring the potential role of marijuana as a component of multimodal pain control. This study aimed to evaluate the impact of self-reported marijuana use on postoperative opioid prescribing patterns in patients undergoing hip and knee arthroplasty.
METHODS
This retrospective study reviewed the medical records of patients treated by a single hip and knee arthroplasty surgeon. Patients were divided into two cohorts based on self-reported marijuana use: those who reported use and those who denied use. The primary outcome was the total morphine milligram equivalents (MME) prescribed within the first 90 days following surgery. Statistical analysis was conducted to compare prescribing patterns between the two groups.
RESULTS
97 patients were surveyed with a mean age of 64 years old. There were 61 females (62.9%) and 26 (37.1%) males. There were 39 (40.2%) primary total hips and 58 (59.8%) primary total knees. Patients who self-reported marijuana use were prescribed significantly higher MMEs within the 90-day postoperative period compared to those who denied marijuana use (983 MME vs. 501 MME, p=0.019). The difference in opioid prescribing patterns suggests that marijuana use may not mitigate postoperative opioid requirements and could potentially be associated with higher opioid consumption.
CONCLUSION
Self-reported marijuana use was associated with increased opioid prescribing in the early postoperative period following hip and knee arthroplasty. These findings highlight the need for further investigation into the relationship between marijuana use and postoperative pain management to better inform clinical practice and optimize multimodal analgesic strategies. .
背景
在美国，与阿片类药物相关的死亡人数每年持续上升，这促使人们寻找替代或辅助性疼痛管理策略。与此同时，大麻的合法性日益提高，使用广泛，且在文化上被接受。在整形外科领域，人们越来越有兴趣探索大麻作为多模式疼痛控制组成部分的潜在作用。本研究旨在评估自我报告使用大麻对接受髋关节和膝关节置换术患者术后阿片类药物处方模式的影响。
方法
这项回顾性研究回顾了由一位髋关节和膝关节置换外科医生治疗的患者的病历。根据自我报告的大麻使用情况，将患者分为两组：报告使用大麻的患者和否认使用大麻的患者。主要结局是术后90天内开具的吗啡毫克当量（MME）总量。进行统计分析以比较两组之间的处方模式。
结果
对97名患者进行了调查，平均年龄为64岁。其中有61名女性（62.9%）和26名男性（37.1%）。有39例（40.2%）初次全髋关节置换和58例（59.8%）初次全膝关节置换。与否认使用大麻的患者相比，自我报告使用大麻的患者在术后90天内开具的MME明显更高（983 MME对501 MME，p = 0.019）。阿片类药物处方模式的差异表明，使用大麻可能无法减轻术后阿片类药物需求，并且可能与更高的阿片类药物消费量相关。
结论
自我报告使用大麻与髋关节和膝关节置换术后早期阿片类药物处方增加有关。这些发现凸显了进一步研究大麻使用与术后疼痛管理之间关系的必要性，以便更好地为临床实践提供信息并优化多模式镇痛策略。
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