The use of statins after hip surgery may not reduce pain levels or the need for opioid medications, according to a study published in the British Journal of Anaesthesia.
In this retrospective study, researchers compared pain outcomes data between adults taking statins (n=611) vs no statins (n=780) following elective hip replacement surgery that was performed using spinal anesthesia between 2005 and 2015.
During the initial 72 hours after elective hip surgery, patients taking statins vs no statins reported pain scores 0.07 higher (95% CI, -0.02, 0.17; P =.74). In addition, the median cumulative intravenous morphine equivalent opioid consumption in the first 72 hours after surgery was 56.5 mg (Q1, 35; Q3, 87.5) for patients taking statins vs 62.5 mg (Q1, 37.5; Q3, 96.9) for patients not taking statins (adjusted ratio of geometric means, 1.01 for statin users vs non-users). Both groups had equivalent opioid consumption, as indicated by the lack of superiority in both directions.
The retrospective nature of this study represents its primary limitation, as this design may have introduced confounders. Adjustment for intraoperative aesthetic components, such as total dose of opioid and methods of sedation, were not adjusted for in this analysis.
Despite that “statins have been suggested to aid in multimodal analgesia by attenuating postoperative inflammation,” this study reveals a clear lack of significant benefit with the use of these medications in a multimodal pain management strategy for hip surgery.
Saasouh W, Leung S, Yilmaz HO, et al. Are perioperative therapeutic doses of statins associated with postoperative pain and opioid consumption after hip surgery under spinal anaesthesia? Br J Anaesth. 2017;119(4):803-811.