Preoperative Diagnosis of Depression Leads to Increased Opioid Tablets Taken After Total Hip Arthroplasty: A Prospective Study

Balancing postoperative analgesia with minimizing opioid consumption remains a challenge. We aim to document trends in opioid consumption for patients undergoing total hip arthroplasty (THA) and hypothesize that preoperative patient education will decrease postoperative opioid consumption. This is a prospective study of patients undergoing elective primary THA. Preoperatively, patients completed a survey regarding opioid-use history, surgical history, and pain tolerance. Patients were randomized to receive preoperative education on opioid use or no formal education. Six weeks postoperatively, patients completed a questionnaire regarding opioid use, disposal, and pain control. Ninety-five patients were included. Preoperative education was not associated with taking fewer narcotic medications (p = 0.790) and did not significantly alter disposal practices (p = 0.255). Depression was correlated with increased opioid use (mean difference 24 tabs, p = 0.001) and linked to longer duration of opioid use postoperatively (20.3 +/- 15.6 versus 7.2 +/- 7.3 days, p < 0.001). History of prior surgical procedure was associated with fewer narcotics taken (mean difference 26 tabs, p = 0.01). Depression is correlated with increased opioid use. Preoperative education did not affect opioid use or disposal frequency. (Journal of Surgical Orthopaedic Advances 30(3):144–149, 2021)

Key words: total hip arthroplasty, opioid, education, pain control, depression, narcotic