Observational studyRegional anesthesia and pain medicine2018
Acute Pain Is Associated With Chronic Opioid Use After Total Knee Arthroplasty.
Observational study in Regional anesthesia and pain medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 53 citations in OpenAlex.
- Iliopsoas plane block versus femoral nerve block for postoperative quality of recovery following hip arthroplasty: a randomized controlled trial.Scientific reports · 2025Trial
- Determination of the 90% Effective Dose of Oliceridine Combined with Propofol for Day-Case Hysteroscopy.Drug design, development and therapy · 2025Trial
- Electroacupuncture alleviates pain after total knee arthroplasty through regulating neuroplasticity: A resting-state functional magnetic resonance imaging study.Brain and behavior · 2023Trial
- APOLLO-2: A Randomized, Placebo and Active-Controlled Phase III Study Investigating Oliceridine (TRV130), a G Protein-Biased Ligand at the μ-Opioid Receptor, for Management of Moderate to Severe Acute Pain Following Abdominoplasty.Pain practice : the official journal of World Institute of Pain · 2019Trial
- Acute Postoperative Pain in Orthopaedic Trauma and Non-Trauma Patients: An Analysis of the China Acute Postoperative Pain Study (CAPOPS).European journal of pain (London, England) · 2025Article
- The effect of adductor canal block on outcomes of total knee arthroplasty: A single centre, historical cohort study.Journal of orthopaedics · 2025Article
- Urine tests for THC in patients undergoing elective inpatient surgery: a nationwide longitudinal electronic health record study in US veterans.British journal of anaesthesia · 2025Article
- Pain profiles and opioid consumption following joint replacement surgery: a prospective observational cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Observational
- Cannabis Use and Inhalational Anesthesia Administration in Older Adults: A Propensity-matched Retrospective Cohort Study.Anesthesiology · 2024Article
- Regional anesthesia improves inpatient but not outpatient opioid demand in tibial shaft fracture surgery.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Opioid Prescribing for Chronic Musculoskeletal Conditions: Trends over Time and Implementation of Safe Opioid-Prescribing Practices.Applied clinical informatics · 2023Article
- Shared decision-making for postoperative opioid prescribing and preoperative pain management education decreases excess opioid burden.Surgical endoscopy · 2023Article
- Predictors of continued opioid use 6 months after total joint arthroplasty: a multi-site study.Archives of orthopaedic and trauma surgery · 2022Article
- Beware the rebound effect: regional anesthesia increases opioid utilization after humerus fracture surgery.Shoulder & elbow · 2022Article
- Perioperative Use of Gabapentinoids and Risk for Postoperative Long-Term Opioid Use in Older Adults Undergoing Total Knee or Hip Arthroplasty.The Journal of arthroplasty · 2022Article
- Regional anesthesia does not decrease opioid demand in pelvis and acetabulum fracture surgery.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Observational
- Regional anesthesia does not decrease inpatient or outpatient opioid demand in distal femur fracture surgery.Archives of orthopaedic and trauma surgery · 2022Article
- Machine learning approach to predicting persistent opioid use following lower extremity joint arthroplasty.Regional anesthesia and pain medicine · 2022Article
- Naloxone Dispensing in Patients at Risk for Opioid Overdose After Total Knee Arthroplasty Within the Veterans Health Administration.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2022Article
- Observational
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesPain scores are routinely reported in clinical practice, and we wanted to examine whether this routinely measured, patient-reported variable provides prognostic information, especially with regard to chronic opioid use, after taking preoperative and perioperative variables into account in a preoperative opioid user population.
methodsIn 32,874 preoperative opioid users undergoing primary total knee arthroplasty at Veterans Affairs hospitals between 2010 and 2015, we compared preoperative and perioperative characteristics in patients reporting lower versus higher acute pain (scores ≤4/10 vs >4/10 averaged over days 1-3). We calculated the propensity for lower acute pain based on all available data. After 1:1 propensity score matching, to identify similar patients differing only in acute pain, we contrasted rates of chronic significant opioid use (mean >30 mg/d in morphine equivalents) beyond postoperative month 3, discharge prescriptions, and changes in postoperative versus preoperative dose categories. Sensitivity analysis examined associations with dose escalation.
resultsRates of chronic significant opioid use (21% overall) differed in patients with lower versus higher acute pain (36% vs 64% of the overall cohort). After propensity matching (total n = 20,926 patients) and adjusting for all significant factors, lower acute pain was associated with less chronic significant opioid use (rates 12% vs 16%), smaller discharge prescriptions (ie, supply <30 days and daily oral morphine equivalent <30 mg/d), and more reduction in dose, all P < 0.001. In sensitivity analysis, dose escalation was 15% less likely with lower acute pain (odds ratio, 0.85; 95% confidence interval, 0.80-0.91).
conclusionsAcute pain predicts chronic opioid use. Prospective studies of efforts to reduce acute pain, in terms of long-term effects, are needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.