Does Preoperative Suzetrigine Impact ASC Opioid Consumption For Total Joint Arthroplasty?

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are some of the most commonly performed surgical procedures. Due to the soft tissue damage sustained intraoperatively, pain is a common occurrence which is frequently treated with opioid analgesics. Conventional wisdom still espouses large numbers of opioids for post-op pain relief. However, opioid related adverse events such as addiction, mental status changes, fall risk, and sedation remain a problem. Suzetrigine is a novel non-addictive FDA approved medication to treat acute pain. Lowering opioid use in the early phases of recovery has been shown to reduce long-term opioid use for patients. This retrospective study evaluated day of surgery opioid requirements for outpatient TKA and THA arthroplasty patients. Patients in the experimental cohort received a 100 mg dose of suzetrigine pre-operatively which the control cohort did not receive. The percentage of patients receiving opioids and the dosage of opioid was recorded during the different recovery phases. Preoperative administration of suzetrigine consistently reduced the percentage of patients requiring opioids at different phases of recovery as well as the total MME consumed per patient in the surgical facility. For patients receiving a TKA, the total required dosing went from 68.8 MME to 53.1 MME (p=0.0002) showing a 23% reduction. For patients receiving a THA, the total required dosing went from 78.4 MME to 51.8 MME (p<0.0001) showing a 34% reduction. This study suggests that suzetrigine significantly reduces day of surgery opioid use and may have implications for early post up recovery as well.