Opioid consumption during hospitalisation among robotic-assisted, computer-assisted, and manual total hip arthroplasty: a retrospective cohort study.
Academic Article
Overview
abstract
BACKGROUND: We examined total opioid consumption during hospitalisation across manual (MA-THA), computer-assisted (CA-THA), and robotic-assisted (RA-THA) total hip arthroplasty. METHODS: This retrospective cohort study (2016-2023, Premier Healthcare database) of patients undergoing unilateral elective THA assessed opioid consumption during hospitalisation and by postoperative day (POD). Two-part mixed-effects models were conducted: first of a logistic regression for opioid use (yes/no) and second a linear regression model of log(opioid consumption) among opioid consumers. RESULTS: During hospitalisation of 584 578 patients, CA-THA was associated with lower odds of any opioid consumption than MA-THA (odds ratio [OR], 0.87; 95% confidence interval [95% CI], 0.80-0.95). RA-THA was associated with higher odds of any opioid consumption than CA-THA (OR, 1.22; 95% CI, 1.08-1.39). Among opioid consumers, CA-THA and RA-THA were associated with a 2% lower total opioid consumption than MA-THA (both multiplicative effects [ME], 0.98; 95% CI, 0.97-0.99). The strongest effect was observed on POD 1: lower odds of opioid consumption for both CA-THA (OR, 0.78; 95% CI, 0.74-0.83) and RA-THA (OR, 0.84; 95% CI, 0.80-0.88) than for MA-THA, and among those who consumed opioids, there was 9% lower (ME, 0.91; 95% CI, 0.90-0.93) and 6% lower (ME, 0.94; 95% CI, 0.93-0.96) opioid consumption for CA-THA and RA-THA, respectively, than for MA-THA. CONCLUSIONS: Among those who consumed opioids, technology-assisted THA was associated with lower opioid consumption than MA-THA, primarily due to differences observed on POD 1. Although these differences are not clinically significant enough to affect decision-making, technology-assisted THA might be associated with anaesthetic techniques that confer improved pain relief in the immediate postoperative period.
