{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T10:51:41Z","timestamp":1771671101713,"version":"3.50.1"},"reference-count":19,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002544"],"award-info":[{"award-number":["UL1TR002544"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2020,8,11]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Total knee arthroplasty (TKA) is associated with a high incidence of continued opioid use beyond the expected period of recovery. The aim of this study was to determine the influence of inpatient opioid consumption on the development of persistent use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Opioid-na\u00efve patients undergoing primary, uncomplicated TKA were included in a prospective, observational study at a single institution. Postoperatively, opioids were prescribed by orthopedic advanced practitioners or resident physicians and administered by registered nurses. Individual inpatient prescriptions were adjusted, as needed, to facilitate optimal recovery conditions. Average hourly inpatient opioid consumption was calculated from total usage between midnight on the day of surgery until the time of hospital discharge. Persistent opioid use was defined as a prescription refill written by the orthopedic surgeon at the 6-week surgical follow-up visit. A multivariable regression model was used to identify independent risk factors associated with persistent use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 351 patients were included in the analysis. Persistent opioid use was identified in 17.4% (61) of patients overall. A history of alcohol abuse (OR 7.80; 95%\u2009CI 2.13 to 28.55, p=0.002) was identified as an independent risk factor. Inpatient opioid consumption in the top quartile (equivalent to more than 10 mg of oxycodone every 4\u2009hours) was not found to be associated with persistent use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Larger amounts of opioid consumed in the hospital following uncomplicated, primary TKA may not be associated with an increased risk of persistent use at 6 weeks among opioid-na\u00efve patients. Patients may have unique risk factors for prolonged opioid use that may not necessarily be apparent in the early postoperative period.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2020-101582","type":"journal-article","created":{"date-parts":[[2020,11,10]],"date-time":"2020-11-10T17:27:15Z","timestamp":1605029235000},"page":"99-103","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Influence of inpatient opioid consumption on persistent use following total knee arthroplasty"],"prefix":"10.1136","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2427-317X","authenticated-orcid":false,"given":"Meredith","family":"Pace","sequence":"first","affiliation":[{"name":"Anesthesiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerri","family":"Gannon","sequence":"additional","affiliation":[{"name":"Anesthesiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Friedland","sequence":"additional","affiliation":[{"name":"Anesthesiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gervase","family":"Spurlin","sequence":"additional","affiliation":[{"name":"Anesthesiology, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lori Lyn","family":"Price","sequence":"additional","affiliation":[{"name":"Tufts Clinical and Translational Science Institute, Tufts University, Medford, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,11,10]]},"reference":[{"key":"2025101111315776000_46.2.99.1","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2017.0504","article-title":"New persistent opioid use after minor and major surgical procedures in US adults","volume":"152","author":"Brummett","year":"2017","journal-title":"JAMA Surg"},{"key":"2025101111315776000_46.2.99.2","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1016\/j.surg.2019.04.016","article-title":"New persistent opioid use among older patients following surgery: A Medicare claims analysis","volume":"167","author":"Santosa","year":"2020","journal-title":"Surgery"},{"key":"2025101111315776000_46.2.99.3","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.cger.2016.06.006","article-title":"Managing pain in older adults: the role of opioid analgesics","volume":"32","author":"Naples","year":"2016","journal-title":"Clin 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Arthroplasty"},{"key":"2025101111315776000_46.2.99.8","doi-asserted-by":"crossref","first-page":"180","DOI":"10.2106\/JBJS.17.00672","article-title":"Excess opioid medication and variation in prescribing patterns following common orthopaedic procedures","volume":"100","author":"Sabatino","year":"2018","journal-title":"J Bone Joint Surg Am"},{"key":"2025101111315776000_46.2.99.9","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00222"},{"key":"2025101111315776000_46.2.99.10","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.athoracsur.2019.06.019","article-title":"Impact of prescribing on new persistent opioid use after cardiothoracic surgery","volume":"108","author":"Brescia","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2025101111315776000_46.2.99.11","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1177\/0363546518819780","article-title":"Risk of prolonged opioid use among opioid-na\u00efve patients after common shoulder arthroscopy procedures","volume":"47","author":"Gil","year":"2019","journal-title":"Am J Sports Med"},{"key":"2025101111315776000_46.2.99.12","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1177\/1071100719851117","article-title":"New persistent opioid use and associated risk factors following treatment of ankle fractures","volume":"40","author":"Gossett","year":"2019","journal-title":"Foot Ankle Int"},{"key":"2025101111315776000_46.2.99.13","doi-asserted-by":"crossref","first-page":"722","DOI":"10.2106\/JBJS.18.00793","article-title":"New persistent opioid use following common forefoot procedures for the treatment of hallux valgus","volume":"101","author":"Finney","year":"2019","journal-title":"J Bone Joint Surg Am"},{"key":"2025101111315776000_46.2.99.14","doi-asserted-by":"crossref","unstructured":"Larach DB , Sahara MJ , As-Sanie S , et al . Patient factors associated with opioid consumption in the month following major surgery. Ann Surg 2019;Publish Ahead of Print.doi:10.1097\/SLA.0000000000003509","DOI":"10.1097\/SLA.0000000000003509"},{"key":"2025101111315776000_46.2.99.15","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1464"},{"key":"2025101111315776000_46.2.99.16","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1213\/ANE.0000000000003564","article-title":"Evidence review conducted for the agency for healthcare research and quality safety program for improving surgical care and recovery: focus on anesthesiology for total knee arthroplasty","volume":"128","author":"Soffin","year":"2019","journal-title":"Anesth Analg"},{"key":"2025101111315776000_46.2.99.17","unstructured":"Calculating total daily dose of opioids for safer dosage. 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