Opioid Use Decreases After Total Hip Arthroplasty

Medication use decreases after hip-replacement surgery, according to a study published in the journal Pain.

Tone Blågestad, PhD, of the University of Bergen, Norway, and colleagues integrated Norwegian national joint replacement and prescription databases to examine medication use by nearly 40,000 patients undergoing total hip arthroplasty (THA) from 2005 to 2011.

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Dr. Blågestad and colleagues analyzed trends in prescription drug use over the course of 2 years: 4 quarters before and 4 quarters after hip-replacement surgery.

The researchers focused their efforts on several classes of drugs typically used to alleviate pain and treat insomnia. They also examined drugs prescribed to treat anxiety and depression.

Nearly 50% of patients filled a prescription for some kind of analgesic in the year before surgery. These drugs included: NSAIDs (38%); opioids (16%); and other non-opioid analgesics (12%). The use of painkillers increased during the last quarter before THA.

Patients drastically increased their use of pain medications in the first quarter after undergoing surgery. For example, the use of opioids, which increased to 28% in the last quarter before surgery, escalated to 65% in the first quarter after THA. Non-opioid analgesics increased to 21% and then to nearly 61% during the same time period.

The use of hypnotic drugs also increased from the quarter before to the quarter after surgery — from 14% to 25%.

Dependence on pain medications and hypnotic drugs decreased as time went on. Opioid use decreased to 14% 1 year after the completion of surgery. NSAID and non-opioid analgesic use decreased to 18% and 13% respectively. Use of hypnotic drugs also decreased, along with medications to treat anxiety.

“Overall, the present results extend the positive effects of THA to include reduced reliance on medication to alleviate symptoms,” Dr. Blågestad and colleagues report. “Our results warrant attention to the increased risk of adverse medication effects occurring with the increased use of both opioids and hypnotics in the recovery phase.”

Reference

Blågestad T, Nordhus IH, Grønli J, et al. Prescription trajectories and effect of total hip arthroplasty on the use of analgesics, hypnotics, antidepressants and anxiolytics: Results from a population of total hip arthroplasty patients. Pain. 2015; doi: 10.1097/j.pain.0000000000000414.