Background and Aims Chronic pain patients are more likely to use opioids and have worse surgical outcomes.1–4Optimization of these patients prior to surgery may have numerous beneficial effects on recovery (Figure 1).5 This study aimed to determine if optimization of opioid users through a pre-surgical pain management consultation was associated with a decreased length of stay and intraoperative opioid requirements in patients who underwent inpatient orthopedic procedures in a large, urban, specialty hospital.
Methods After Institutional Review Board approval (IRB#2019–0206), a retrospective chart review of institutional data from 2016–2021 was performed to identify patients who required a complex/chronic pain consultation during hospitalization. From this cohort, pre-operative opioid users (defined as an active opioid prescription prior to admission) were identified and stratified based on completion of a pain pre-surgical screening consultation. Outcomes of interest included length of stay and intraoperative opioid administration. Linear regression models, adjusting for sex, BMI, ASA status, and primary anesthesia type were run to determine the association between pain pre-surgical screening and outcomes of interest.
Results After adjusting for covariates, pre-surgical screening consultation was not associated with a significant reduction in length of stay in TKA, THA or spinal procedures, but was associated with significantly higher intraoperative methadone use in TKA patients (1.92 OME [95% CI = 0.21, 3.63], p = 0.028).
Conclusions Though we did not find associations between pre-surgical screening consultations and length of stay and certain intraoperative opioid administrations, future analyses may report potential associations between pre-surgical screening consultations and cumulative opioid use and patient-reported outcomes.
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