{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:04:10Z","timestamp":1792886650183,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs) are one of the mainstays of multimodal pain management. While effective for acute pain control, recent pre\u2010clinical evidence has raised concerns regarding an association between NSAIDs and chronic pain and potential opioid use. Our objective was to explore the association between peri\u2010operative use of prescription NSAIDs and the need for continued opioid prescriptions lasting 90\u2013180\u2009days in previously opioid\u2010na\u00efve patients undergoing total knee arthroplasty. A database of health claims in the USA was used to identify all opioid\u2010na\u00efve adult patients who underwent primary knee arthroplasty between January 2010 and October 2021. We evaluated the magnitude of association between peri\u2010operative prescription NSAID claims and claims for opioids at 90\u2009days postoperatively using multivariable logistic regression models. Secondary outcomes included: the magnitude of association between peri\u2010operative NSAID prescription and claims for opioids at 180\u2009days postoperatively; and identifying other potential factors associated with opioid claims at 90\u2009days postoperatively. After risk adjustment using multivariable logistic regression models in the 789,736\u2010patient cohort, the adjusted odds ratio (95%CI) for a continuous claim of opioids at 90 and 180\u2009days postoperatively among patients with a peri\u2010operative NSAID prescription within 30\u2009days was 1.32 (1.30\u20131.35), p\u2009&lt;\u20090.001; and 1.12 (1.10\u20131.15), p\u2009&lt;\u20090.001, respectively. This estimate of effect remained robust at 90\u2009days after accounting for known potential confounders, including pre\u2010existing knee pain and acute postoperative pain severity. Similar analysis of other pain medications (e.g. paracetamol) did not detect such an association. This population\u2010based cohort study suggests that peri\u2010operative prescription NSAID use may be associated with continued opioid prescription claims at 90 and 180\u2009days after knee arthroplasty, even after adjusting for other observed covariates for continuous opioid claims. These novel findings can inform clinical decision\u2010making for post\u2010surgical pain management, risk\u2013benefit discussions with patients and future research.<\/jats:p>","DOI":"10.1111\/anae.16259","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T09:48:19Z","timestamp":1708595299000},"page":"725-734","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Association of peri\u2010operative prescription of non\u2010steroidal anti\u2010inflammatory drugs with continued prescription of opioids after total knee arthroplasty: a retrospective claims\u2010based cohort study"],"prefix":"10.1111","volume":"79","author":[{"given":"N.","family":"Hussain","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Wexner Medical Center, The Ohio State University  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Brull","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Management Women's College Hospital and Toronto Western Hospital, University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Gilron","sequence":"additional","affiliation":[{"name":"Departments of Anesthesia and Perioperative Medicine and Biomedical and Molecular Science, Centre for Neuroscience Studies, School of Policy Studies Queen's University  Kingston ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. E.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Wexner Medical Center, The Ohio State University  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Department of Orthopedics UC Davis Health  Sacramento CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. S.","family":"D'Souza","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine Mayo Clinic  Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Abdel\u2010Rasoul","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, College of Medicine, Center for Biostatistics The Ohio State University  Columbus OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Pain Management Toronto General Hospital, University of Toronto  Toronto ON Canada"},{"name":"Department of Anesthesiology and Pain Medicine University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J. L.","family":"McCartney","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Sunnybrook Health Sciences Centre University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. W.","family":"Abdallah","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine and the Ottawa Hospital Research Institute University of Ottawa  Ottawa ON Canada"},{"name":"Department of Anesthesia, and the Li Ka Shing Knowledge Institute St. Michael's Hospital, University of Toronto  Toronto ON 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