Background: The national opioid epidemic has highlighted the critical importance of opioid stewardship within orthopaedic surgery. Previous research has identified a diagnosis of anxiety disorder as significantly associated with postoperative opioid consumption following upper extremity procedures. Purpose/Hypothesis: This study aimed to broaden this understanding by investigating whether measured levels of preoperative anxiety, rather than a broad diagnosis, in patients undergoing arthroscopic rotator cuff repair (ARCR) affected postoperative opioid utilization. It was hypothesized that, in opioid-naive patients, a higher preoperative anxiety score would be associated with increased postoperative opioid consumption. Study Design: Cohort study, Level of evidence, 2. Methods: Opioid-naive patients undergoing primary ARCR between March 2024 and February 2025 were prospectively enrolled at a multicenter institution. Preoperative patient-reported outcome measures were collected using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, Single Assessment Numeric Evaluation, and Patient-Reported Outcomes Measurement Information System Short Form (PROMIS SF) Anxiety 8a. Postoperative opioid use was recorded via a patient-completed pain journal and converted into morphine milligram equivalents (MMEs). General linear models (GLMs) were developed to evaluate the relationship between preoperative anxiety and total MMEs, days of opioid use, and MMEs per day, while controlling for age, sex, and California Area Deprivation Index (ADI). Statistical significance was set at P < .05. Results: A total of 64 patients were included with a mean age 63.5 ± 12.2 years (male, n = 32; mean body mass index, 27.1 ± 4.7 kg/m 2 ). The mean total postoperative opioid usage was 119.5 ± 118.7 MMEs over 5.8 ± 4.7 days, with a mean MME per day of 19.0 ± 11.6. Three GLMs showed no significant association between preoperative PROMIS Anxiety T-scores and total MMEs ( P = .15), days opioids were taken ( P = .13), or MME per day ( P = .58). Covariates including age, sex, and ADI were not significant in any model. Conclusion: Levels of preoperative anxiety in opioid-naive patients undergoing primary ARCR had no significant effect on total postoperative opioid usage, the number of days opioid medication was taken, or the adjusted daily opioid usage.
Simpson et al. (Wed,) studied this question.