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May 29, 2026Journal of the American Academy of Orthopaedic Surgeons

Risk of Overdose and Adverse Events With Concomitant Opioids and Gabapentinoid Use After Total Joint Arthroplasty

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Authors

PDPaolo Tristian DomingoKaiser Permanente San Diego Medical CenterGBGarrett K. BergerUniversité Gaston BergerPGPatricia GrayUniversité Gaston Berger

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Overview

Retrospective cohort study compares opioid overdose and adverse events with opioid and gabapentinoid combinations after total joint arthroplasty, suggesting no significant differences.

Key Points

  • The aim was to evaluate safety outcomes of opioids alone versus opioids plus low-dose gabapentinoids in opioid-naïve patients post-total joint arthroplasty.
  • Multicenter, population-based, retrospective cohort study within a health system
  • Included opioid and gabapentinoid-naïve patients undergoing total joint arthroplasty from 2018 to 2024
  • Patients were grouped based on prescription after surgery—opioids alone or opioids plus gabapentinoids.
  • Total cohort included 36,351 patients, with 29,009 in the opioids-alone group and 7,342 in the combined group.
  • There were 19 opioid-related overdose events (0.05%), with 14 in the opioids-alone group and 5 in the combined group (P=0.3).
  • 233 patients (0.6%) had emergency department admissions due to adverse events; 200 from the opioids-alone group and 33 from the combined group, showing no significant difference.

Cite This Study

Domingo et al. (2026) studied this question.

synapsesocial.com/papers/6a192df7fab5b468c4416f78https://doi.org/10.5435/jaaos-d-25-01651
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Gabapentin, opioids, and the risk of opioid-related death: A population-based nested case–control study2017 · 541 citations
  2. 2Multimodal Analgesic Therapy With Gabapentin and Its Association With Postoperative Respiratory Depression2016 · 196 citations
  3. 3Pregabalin and the Risk for Opioid-Related Death: A Nested Case–Control Study2018 · 177 citations
  4. 4Association of Gabapentinoids With the Risk of Opioid-Related Adverse Events in Surgical Patients in the United States2020 · 127 citations
  5. 5Coprescription of Opioids With Other Medications and Risk of Opioid Overdose2021 · 41 citations