Chronic pre-operative opioid use and acute XXXX after fast-track total knee arthroplasty.

@entity1 @entity1286 @entity158
BACKGROUND: Pre-operative opioid use has been suggested to increase post-operative @entity158 and opioid consumption after total knee arthroplasty (TKA), but previous studies are either retrospective or inhomogeneous with regard to surgical procedures or control of analgesic regimes, or with few opioid-treated @entity1 , hindering firm conclusions. METHODS: In a prospective observational study, we investigated the effect of > 4 weeks pre-operative opioid use [none vs. low dose (< 30 mg @entity1286 equivalents (eq.)) vs. high dose (> 30 mg @entity1286 eq.] in @entity1 scheduled for primary, unilateral TKA. All @entity1 had well-defined multimodal opioid-sparring perioperative analgesic therapy, and continued any pre-operative opioid medication. The primary outcome was differences between groups in @entity158 at rest and during walk for the first 6 post-operative days. RESULTS: Among 123 @entity1 included, 115 were available for final analysis (93% follow-up rate). Post-operative @entity158 during walk was significantly increased in both opioid-treated groups vs. non-opioid-treated @entity1 (P < 0.009). Secondary analysis of combining all pre-operatively opioid-treated @entity1 vs. opioid-free @entity1 , showed significantly increased @entity158 at rest and walk and increased post-operative opioid requirement - excluding pre-operative dosage - during the first post-operative week in opioid-treated @entity1 (P = 0.001 and P = 0.007, respectively). CONCLUSION: Pre-operative opioid use increases the risk for post-operative @entity158 at rest and walk, and increased opioid consumption after TKA.
