CC BY-NC-ND 4.0 · Joints 2018; 06(03): 157-160
DOI: 10.1055/s-0038-1673405
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Opiate Pain Medication Consumption in Cigarette Smokers following Total Hip Arthroplasty

Jennifer I. Etcheson
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Chukwuweike U. Gwam
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Nicole E. George
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Naval Walia
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Christophe Jerjian
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Ga-ram Han
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Sana Virani
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Seth J. Miller
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
,
Ronald E. Delanois
1  Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland, United States
› Author Affiliations
Further Information

Publication History

18 April 2018

26 August 2018

Publication Date:
18 October 2018 (eFirst)

  

Abstract

Purpose The purpose of the present study was to assess perception of pain and pain management in smokers versus nonsmokers who received a total hip arthroplasty (THA).

Methods Patients who underwent THA from 2010 to 2016 were propensity score matched 1:1 based on race, body mass index, age, and sex. This yielded 124 smokers and 124 nonsmokers. Pain intensity was quantified using area under the curve for visual analog scale pain scores. Opioid consumption was determined using a morphine milliequivalent (mEq) conversion algorithm. An independent samples t-test and Chi-square analysis was conducted to assess continuous and categorical variables respectively.

Results Smokers experienced a nonsignificantly increased pain intensity (198.1 vs. 185.7; p = 0.063). Smokers demonstrated significantly higher opioid consumption in both immediate postoperative (65.9 vs. 59.3 mEq; p = 0.045) and 90 days postoperative periods (619.9 vs. 458.9 mEq; p = 0.029).

Conclusion Our study demonstrated a nonsignificantly increased pain intensity, and (in both the immediate and 90 days postoperative periods) a significantly higher opioid consumption following THA in patients who smoke cigarettes. This may be due to a relatively small effect size, warranting the need for larger prospective studies. Nevertheless, arthroplasty surgeons should encourage preoperative smoking cessation and alternative nonopioid analgesics to smoking patients receiving THA.

Level of Evidence This is a level III, retrospective cohort study.