Tobacco users reported increased postoperative pain and narcotic use after total shoulder arthroplasty, a study in the Journal of Shoulder and Elbow Surgery found. Former tobacco users had a postoperative course similar to nonusers.
Here are four things to know:
1. To determine the potential impact of tobacco as a risk factor, the study authors evaluated postoperative pain, narcotic use, length of stay, revisions and complications in the global 90-day episode of care for patients undergoing anatomic total shoulder arthroplasty who were current tobacco users, former users or nonusers.
2. A database search identified 163 patients with primary anatomic TSA done for glenohumeral arthritis, and divided these patients into three groups: 28 current tobacco users, 88 nonusers and 47 former users. All surgeries were completed with the same technique and implants.
3. The current tobacco use group had significantly higher visual analog scale scores preoperatively and at 12 weeks postoperatively than nonusers and former users. In current tobacco users, mean improvement in visual analog scale scores was significantly less. Cumulative oral morphine equivalent use at 12 weeks was significantly higher in current tobacco users than in nonusers and former users, and the average oral morphine equivalent per day was also significantly higher in the current tobacco users than in nonusers and former users. There were no significant differences in length of stay or complications.
4. Since former tobacco users had a postoperative course similar to nonusers, the authors reason that discontinuing tobacco use can improve a patient's episode of care performance after TSA.
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