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A Simple Aspirin Routine Cut Opioid Use Following Rotator Cuff Surgery

by Abby Lee

There was some interesting news to come out of one of the recent Academy of Orthopedic Surgeons (AAOS) meetings. During the Fall 2021 meeting a study was presented displaying some encouraging news for orthopedic surgeons looking to help their patients rely less on opioid medications post-surgery. Opioid medication is still the dominant pain management treatment following most orthopedic surgeries. However, opioid prescriptions do have some significant concerns when looking at the potential for dependence and abuse. The study involved 57 patients aged 30 to 80 who underwent arthroscopic rotator cuff repair surgery. What the researchers ultimately found is that patients who incorporated regular doses of acetaminophen during both preoperative and postoperative monitoring ended up taking less of their prescribed opioid pills as well. With approximately 250,000 rotator cuff surgeries performed in the US each year, something as simple as incorporating doses of Aspirin before surgery and after surgery could significantly cut down on the amount of opioid pills consumed. 

During this study, the patients were split into 3 groups. Group 1 (control 1) received 5 mg of oxycodone every six hours as needed and 1000 mg acetaminophen every six hours as needed after the surgery. These patients had the option to take both, one or the other, or neither.

Group 2 (control 2) received only 5 mg of oxycodone every six hours as needed without any acetaminophen. 

Group 3 received 1000 mg acetaminophen every six hours one day before and after their surgery. This was decreased to every eight hours during postop days two through five. These patients were also allowed to take 5 mg of oxycodone postoperatively every six hours as needed. 

The results showed that the patients who were prescribed the 1000 mg of acetaminophen before and after their surgery took approximately ten fewer 5 mg oxycodone pills during the first week than the other two groups. All patients were also asked a series of questions every day during the first week after surgery regarding their pain and medication consumption. The patients in group 3 reported much better scores on a 0-100 scale for pain control than the other two groups. 

This presents a very interesting and encouraging example for other orthopedic practices to experiment with. Acetaminophen has been used successfully for a very long time while displaying minimal side effects. While this method of treating pain and trying to limit the need for opioid pain medication following surgery has tremendous potential, there still needs to be more work done on the subject, especially following more intensive procedures. Would this also show the same type of potential following a joint replacement for instance? It is great to see the medical community actively trying to curb the opioid dilemma. While there will always be a need for stronger pain management solutions, sometimes little things such as this can make a huge difference. 

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Reference:

https://pubmed.ncbi.nlm.nih.gov/33774169/

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