Retrospective study on pre- and postoperative morphine equivalents demand in patients who underwent rotator cuff repair surgery

Abstract

Background: Aim was to evaluate pre- and postoperative morphine milligram equivalent (MME) demands in patients undergoing rotator cuff repair (RCR), and identify demographic or clinical factors associated with postoperative opioid use.

Methods: A retrospective case series of 35 patients was conducted who underwent RCR between 2023 and 2024 at two orthopedic centers. Demographic data, preoperative pain scores, and opioid use (MME) were extracted. Postoperative opioid consumption was assessed at 90 days. Paired comparisons, subgroup analyses (sex, age group, smoking status), and linear regression were performed to evaluate predictors of postoperative opioid use.

Results: Postoperative opioid use at 90 days was significantly lower compared with preoperative levels (mean paired difference-18.3 MME, t=-2.82, p=0.0106, Hedges’ g=-0.62). No significant differences in 90-day MME were observed by sex (p=0.951), age group (p=0.271), or smoking status. Preoperative pain severity was not predictive of postoperative opioid use (slope=1.86 MME/point, p=0.411, R²=0.034).

Conclusions: Patients undergoing RCR demonstrated a significant reduction in opioid use at 90 days postoperatively, with no major demographic or clinical predictors of postoperative demand. These findings suggest that current prescribing practices may exceed actual consumption and highlight the importance of tailoring opioid prescriptions and integrating multimodal analgesia to reduce unnecessary exposure while maintaining adequate pain control.