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    moet97@stanford.edu
    University - Scholar Department: Anesthesiology, Perioperative and Pain Medicine Position: Postdoctoral Scholar

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All Publications

  • Factors associated with higher inpatient opioid consumption after primary total knee arthroplasty: a retrospective tertiary centre analysis. The Knee Takenoshita, M., Fontalis, A., Lisacek-Kiosoglous, A. B., Oliver, T., Robinson, A., Wignadasan, W., Haddad, F. S. 2025

    Abstract

    PURPOSE: To characterize inpatient postoperative opiate consumption(OC) and identify risk factors associated with high OC among total knee arthroplasty(TKA) patients.METHODS: In this retrospective single centre cohort study, 1,550 TKAs from May 2019 to July 2023 were analysed using electronic healthcare records. Clinical data was collected, including anaesthesia type, post anaesthesia care unit(PACU) admissions, implant fixation, operative duration, peri-operative haemoglobin levels, surgical technique, as well as OC(oral morphine milliequivalents, MME) during inpatient stay. The correlation between OC 24h post operatively and total inpatient OC, as well as average daily inpatient OC, were assessed with Spearman's Rank-Order correlation coefficient. Multivariate logistic regression identified predictors of high opioid use, defined as the top quartile of total inpatient opioid consumption.RESULTS: The cohort included 1,077 females (69.5%) and 473 males (30.5%), with robotic TKA performed in 786 cases (50.7%). Median OC MME for 0-24h post op, 24-48h post op and 48-72h post op was 42mg (IQR 21.0-70.1), 29mg (12.0-45.0), 12mg (0.0-30.0) respectively. Median total inpatient OC for the cohort was 96.0mg MME (IQR=49.0-165). Opiate use decreased by 71.4% from day 1 to day 3 post operatively. Strong positive correlations were found between early OC (24-48h post op) and total inpatient OC (rs(1548)=0.717, p<0.001). On average, 86.5% of total inpatient opiates were consumed in the first 72h post operatively. Higher opioid use was significantly associated with earlier admission year, younger age, increased body mass index(BMI), PACU admission, ASA 3 or 4 and general anaesthesia.CONCLUSIONS: Daily opiate use fell rapidly by the third postoperative day, whilst high OC within the first 24-48h was associated with higher opiate use overall. Younger age, higher BMI and general anaesthesia were associated with higher opiate use. These insights can help tailor pain management strategies for patients at higher risk of opioid reliance during their inpatient stay.

    View details for DOI 10.1016/j.knee.2025.11.005

    View details for PubMedID 41309352