Key result
Perioperative statin use was associated with higher total morphine equivalent consumption through postoperative day 3 compared to non-use (mean difference 30.14 mg; 95% CI 15.93-44.35; p<0.001).
Why the study?
Does perioperative statin use affect postoperative opioid consumption in patients undergoing total knee arthroplasty?
Observational (n=1,088)
No
Does perioperative statin use affect postoperative opioid consumption in patients undergoing total knee arthroplasty?
Mean Difference: 30.14 (95% CI 15.93–44.35)
Absolute Event Rate: 525.4% vs 495.3%
p-value: p=<0.001
Perioperative statin use is associated with a statistically significant but clinically marginal increase in postoperative opioid consumption after total knee arthroplasty.
May warrant monitoring opioid needs with perioperative statins; hypothesis-generating association leaves causality and practice change open.
BACKGROUND AND OBJECTIVES: Data is insufficient to determine whether perioperative statin use increases or decreases postoperative pain. This study aimed to investigate the association between perioperative statin use and pain outcomes after total knee arthroplasty performed under spinal anesthesia. METHODS: This is a retrospective, observational study based on medical records from a tertiary hospital between January 2005 and October 2017. Medical records of patients who underwent elective total knee arthroplasty under spinal anesthesia as inpatients were analyzed. Pain outcomes were compared through postoperative day (POD) 3 in patients who were taking statins perioperatively versus patients who were not taking statins. RESULTS: A total of 1088 propensity-matched participants were included in the final analysis (544 patients in the statin group and 544 patients in the non-statin group). The total morphine equivalent consumption through POD 3 was higher in the statin group than in the non-statin group (mean (SD), statin group: 525.4 (119.7) vs non-statin group: 495.3 (115.3), 95% CI of the difference: 15.9 to 44.4, p<0.001). In the linear regression analysis, the total morphine equivalent consumption through POD 3 was 30.14 mg higher in the statin group compared with the non-statin group (95% CI 15.93 to 44.35; p<0.001). CONCLUSIONS: Perioperative statin use is associated with a significant increase in postoperative opioid consumption after total knee arthroplasty performed under spinal anesthesia; however, this increase was so marginal that its clinical importance remains controversial.
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Oh et al. (2019) conducted an observational in Total knee arthroplasty (n=1,088). Perioperative statin use vs. No perioperative statin use was evaluated on Total morphine equivalent consumption through postoperative day 3 (MD 30.14, 95% CI 15.93 to 44.35, p=<0.001). Perioperative statin use was associated with higher total morphine equivalent consumption through postoperative day 3 compared to non-use (mean difference 30.14 mg; 95% CI 15.93-44.35; p<0.001).
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