Risk Factors for Increased Consumption of Narcotics After Hi
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The goal of this study was to investigate whether prescribing less opioids after hip arthroscopy results in less total postoperative utilization without compromising analgesia and identify risk factors for increased use.

This study randomized 111 patients to receive either 30 or 60 tablets of hydrocodone/acetaminophen 10 to 325 mg after hip arthroscopy. Demographic information, pain instruments, and scores including International Hip Outcome Tool (iHOT-12) were collected preoperatively.

Postoperatively, patients were contacted over the course of 3 weeks to determine their Numeric Pain Rating Scale scores, total number of tablets taken/leftover, and the last day that they required narcotic pain medications, which were calculated and compared for each group. Preoperative variables that increased the risk of higher narcotic pain medication requirements were assessed.

--Patients in the 60-tablet group had significantly more tablets leftover than the 30-tablet group and had no significant difference in Numeric Pain Rating Scale scores at 24 hours, 48 hours, or final follow-up.

--The 30- and 60-tablet groups demonstrated no significant difference in average tablets consumed, respectively.

--Risk factors for increased postoperative opioid use included preoperative opioid use (B = 12.62) or muscle relaxant use (B = 22.45) within 1 year preoperatively.

--Preoperative iHOT-12 scoring also significantly predicted postoperative opioid consumption in this cohort (B = -0.25).

In conclusion, 30 tablets can be greatly lowered following hip arthroscopy compared to 60 without impairing postoperative pain control, by prescribing 30 pills. The total opioid use did not alter the total pills prescribed by this cohort. Preoperative variables, including opioid or relaxing muscle usage and iHOT-12, can be utilized to predict the demand for the postoperative opiate.

Source: https://journals.lww.com/jaaos/Abstract/2021/06150/Risk_Factors_for_Increased_Consumption_of.6.aspx