BJA open · 2026
Opioid consumption during hospitalisation among robotic-assisted, computer-assisted, and manual total hip arthroplasty: a retrospective cohort study.
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Giannakis Periklis, Rowe Juliet E, Ren Renee, Reisinger Lisa, Illescas Alex, Sideris Alexandra, Cozowicz Crispiana, Wang Junying, Zhuang Sophia T, Covin Sara E, Maalouf Daniel, Liu Jiabin, Poultsides Lazaros, Memtsoudis Stavros G, Marx Robert G, Poeran Jashvant, Della Valle Alejandro Gonzalez
Аннотация
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.
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.