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Getting opioids during a knee replacement could make patients more likely to ask for them afterward. A new study found that nearly 30% of opioid-naive patients filled an opioid prescription after total knee arthroplasty (TKA), with intraoperative IV opioid exposure being a key driver. Researchers say a multimodal, opioid-minimizing approach during hospitalization could help break the cycle.
A new retrospective study suggests that exposing opioid-naive patients to IV opioids during total knee arthroplasty (TKA) hospitalization may prime them to request more opioids after they go home. Researchers analyzed 141 patients who underwent TKA between 2020 and 2023 and found that nearly 30% filled an opioid prescription post-discharge — even though opioids were only prescribed upon patient request.
The data showed that patients who received intraoperative IV opioids were significantly more likely to end up in the opioid-prescribed group compared to those who did not. Medicaid-enrolled patients were also more likely to fill a post-op opioid prescription. On the flip side, patients who avoided opioids reported less pain, better quality of life, and improved postoperative function.
By the Numbers:
Why it matters: This is reportedly the first study to link intraoperative IV opioid exposure in the post-anesthesia care unit to increased post-TKA opioid prescribing. The findings make a strong case for coordinated, opioid-minimizing pain protocols across the entire surgical team — from anesthesiologists to orthopedic surgeons — to curb unnecessary opioid use after joint replacement.
