Consensus Statement: Toward Opioid-Free Arthroplasty: A Leadership Forum

Waldman, Seth A.; Shapiro, Louis A.; Albert, Todd J.; Schairer, William W.; Rodríguez-Merchán, E. Carlos; Soffin, Ellen M.; Wu, Christopher L.; Barnes, Mark; Rich, Alex; Avery, Jonathan; Rieder, Travis N.

doi:10.1007/s11420-018-09664-w

Cited by 3 publications

(4 citation statements)

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“…There is disagreement whether 'opioid equivalency' permits the aggregation of trials in meta-analyses [36]. We think that non-opioid analgesics should be used whenever possible and that trials should report cumulative opioid consumption, given concerns of excessive peri-operative opioid use [37][38][39]. The increased reporting of mobility outcomes reflects increasing recognition of early mobilisation as a core element of rehabilitation and enhanced recovery protocols [40,41].…”

Section: Resultsmentioning

confidence: 99%

A systematic review of pain outcomes reported by randomised trials of hip and knee arthroplasty

et al. 2020

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Summary It is difficult to pool results from randomised clinical trials that report different outcomes. We want to develop a core set of pain‐related outcomes after total hip or knee arthroplasty, the first stage of which is to systematically review published outcomes. We searched PubMed, Embase and CENTRAL for relevant trials to January 2020. We identified 165 outcomes from 565 trials with 50,668 participants, which we categorised into six domains: pain; analgesic consumption; quality of care; adverse events; mobility; and patient‐reported outcome measures. The outcome in each domain reported by most trials was: visual analogue score for pain, 401 (71%); morphine consumption, 212 (38%); length of hospital stay, 166 (29%); nausea or vomiting, 425 (75%); range of motion, 173 (31%); and patient satisfaction score, 181 (32%). A primary outcome was reported in 281 (50%) trials: 101 (18%) trials reported consumption of rescue analgesics and 95 (17%) trials reported pain. We plan to publish a consensus on outcomes that should be reported in postoperative pain trials after hip or knee arthroplasty.

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Section: Resultsmentioning

confidence: 99%

A systematic review of pain outcomes reported by randomised trials of hip and knee arthroplasty

et al. 2020

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“…It has recently been reported that although opioids have been widely used for pain control following TKA, multiple level I and II studies have been published in recent years supporting the use of local infiltration analgesia and multimodal blood loss prevention approaches for improving pain control and accelerating recovery after TKA [31,32]. In another recent report, Waldman et al strongly recommended that institutions ensure non-opioid-based comprehensive pain management and multimodal and regional anesthesia strategies for TKA [33]. These approaches have been demonstrated to diminish opioid use, increase patient satisfaction, and shorten lengths of stay.…”

Section: Opioid Usementioning

confidence: 99%

Revision Total Knee Arthroplasty: Epidemiology and Causes

Rodríguez-Merchán

Encinas-Ullán

Gómez-Cardero

2019

Revision Total Joint Arthroplasty

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“…Waldman et al [21] 2019 This "consensus statement: toward opioid-free arthroplasty: A leadership forum" recommended a checklist for prescribers of opioid analgesia after TKA.…”

Section: Authors Year Findings Commentsmentioning

confidence: 99%

“…In 2019 Waldman et al have reported a consensus statement entitled "toward opioid-free arthroplasty: a leadership forum", recommending a checklist for prescribers of opioid analgesia after TKA, and some important guidelines shown in Table 2 [21] .…”

Section: Authors Year Findings Commentsmentioning

confidence: 99%

The use of燨pioids爄n燭otal Knee Arthroplasty燩atient: Main Characteristics, Risk燜actors and Adverse Events

Rodríguez-Merchán¹

2019

International Journal of Orthopaedics

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Opioids are frequently used for the treatment of preoperative and postoperative pain among patients undergoing total knee arthroplasty (TKA) and revision TKA (RTKA). The greatest risk for prolonged opioid use after TKA is preoperative opioid use. Despite the effectiveness of multimodal postoperative pain protocols, younger patients with preoperative history of narcotic use require additional opioids and are at a higher risk for complications and a greater length of stay. At 90 days, respiratory complications were the most common opioid-related adverse events (TKA: 6%; RTKA: 8%), followed by postoperative nausea and vomiting (TKA: 3%; RTKA: 4%), and urinary retention complications (TKA: 3%; RTKA: 3%). For TKA, risk factors for respiratory complications included older age, lower socioeconomic status, more comorbidities, obesity, chronic obstructive pulmonary disease, white race, and patients in the Mid-REVIEW

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Consensus Statement: Toward Opioid-Free Arthroplasty: A Leadership Forum

Cited by 3 publications

References 0 publications

A systematic review of pain outcomes reported by randomised trials of hip and knee arthroplasty

A systematic review of pain outcomes reported by randomised trials of hip and knee arthroplasty

Revision Total Knee Arthroplasty: Epidemiology and Causes

The use of燨pioids爄n燭otal Knee Arthroplasty燩atient: Main Characteristics, Risk燜actors and Adverse Events

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