Abstract
The purpose of this study is to identify patterns of postoperative narcotic use and
determine the impact of psychosocial and perioperative factors on postoperative opioid
consumption following arthroscopic knee surgery. Fifty consecutive patients undergoing
arthroscopic knee surgery were prospectively enrolled. Patients were contacted via
telephone at 1 week postoperatively to report their pain level and opioid consumption.
The patient was contacted again at 2 weeks, 4 weeks, and 90 days as necessary until
opioid cessation, at which time the patient's plan for unused pills was inquired.
Opioid consumption was compared using t-tests and one-way analysis of variance for demographic and surgical factors. Linear
regression was used to determine whether the Pain Catastrophizing Scale (PCS), Resilience
Scale (RS-11), International Knee Documentation Committee questionnaire, or patient-reported
pain at 1 week predicted higher opioid consumption. The average morphine equivalent
dose of opioid consumption was 142 mg. Sixty-four percent consumed less than 100 mg,
and 68% discontinued opioid use by 1 week postoperatively. Seventy-four percent reported
surplus pills, and 49% of those patients plans for pill disposal. Factors associated
with higher consumption included undergoing a major procedure, having a regional anesthesia
block, and higher area deprivation index score (p < 0.05). Higher PCS scores and reported average pain level at 1 week were predictive
of higher opioid consumption (p < 0.05). In conclusion, a majority of patients undergoing outpatient knee surgery
did not require the entirety of their narcotic prescription. The majority of patients
consumed less than 100 mg of morphine equivalents and discontinued opioid use by 1
week postoperatively. Ligament reconstruction, living in an area with a higher index
of deprivation, and higher score on the PCS were associated with greater opioid consumption.
Overall, patient knowledge regarding opioid disposal was poor, and patients would
likely benefit from additional education prior to surgery.
Keywords
opioid consumption - knee arthroscopy - pain catastrophizing - resilience
