Presurgical and Postsurgical Opioid Rates in Patients Undergoing Total Shoulder Replacement Surgery.

Abstract Background The purpose of this study was to describe the pre- and postsurgical opioid prescription rates and average morphine milligram equivalents (MME) per day in patients undergoing total shoulder replacement (TSR) procedures. Methods Patients undergoing TSR were identified from the electronic health records (EMR). In addition to patient demographics, opioid prescription 12-months presurgery and postsurgery were recorded. Patients were categorized into two groups: patients with no opioid prescriptions within 12 months before surgery and patients with an opioid prescription after surgery. McNemar tests were conducted to test for significant presurgical to postsurgical changes in opioid rate changes. The Wilcoxon signed rank test was used to test for significant pre- to postsurgical changes in average MME/day/person, and bivariate logistic regression analyses and covariate-adjusted logistic regressions were used to predict postsurgical opioid prescriptions. Results Overall, 1,076 patients underwent TSR. More than 900 patients received presurgical opioid prescriptions. There was a significant increase (p = .0015) in pre-surgical to postsurgical prescription rates. Postsurgical opioid prescriptions were 4.6 times more likely to be prescribed to a pre-surgical non-opioid patient than an opioid patient (p Conclusions Although presurgical non-opioid patients were more likely to receive a postsurgical opioid prescription, based on dosage, most patients were at low risk for an opioid-related overdose or death according to CDC guidelines.