Comparison of Opioid Requirements and Analgesic Response in Opioid-Tolerant versus Opioid-Naive Patients After Total Knee Arthroplasty

Description: Study Objectives. To compare opioid requirements in opioid-tolerant and opioid-naïve patients after total knee arthroplasty, and to compare pain scores, sedation scores, and adverse effects between the groups.
Conclusion. After total knee arthroplasty, patients tolerant to opioids required significantly more opioids in the PACU and up to 48 hours after discharge from the PACU than did opioid-naïve patients. Opioid-tolerant patients also experienced greater pain during the first 24 hours after discharge from the PACU; however, sedation scores and adverse effects did not appear to be significantly different at any of the time periods studied. Clinicians need to be aggressive with pain management immediately after surgery and ensure that patients restart any opioid treatment at home as soon as possible.
Asad E. Patanwala, Pharm.D.; Donna L. Jarzyna, R.N., M.S.; Michael D. Miller, M.D.; Brian L. Erstad, Pharm.D Pharmacotherapy. 2008;28(12):1453-1460.