Poster 197: Thresholds for Preoperative Opioid Use in Arthroscopic Rotator Cuff Repair that Negatively Influence Postoperative Clinical Outcomes

Objectives: The objective of this study was to evaluate preoperative opioid use along a spectrum better understand the role that has on postoperative outcomes. Methods: A consecutive series patients undergoing arthroscopic RCR from 2018 2020 were included. Preoperative within one year surgery determined using state prescription drug monitoring program (PDMP). Cumulative morphine milligram equivalents (MME) prescriptions prior and number days last prescribed before determined. Postoperative outcomes at 3 6 months included visual analog scale (VAS) for pain American Shoulder Elbow Surgeons Score (ASES). proportion achieving patient acceptable symptom (PASS) VAS ASES Multivariate generalized estimating equations models utilized determine influence outcome scores with receiver operator characteristic (ROC) analysis. Results: 763 (47.6% male) mean age 60.2 + 10.0 years 488 (64%) had no history RCR, while 275 (36%) an RCR. Compared without use, average value 7.9 points lower (p<0.001), 1.0 greater (p< 0.001). PASS achieved in 28% 56% opioids compared 46% 59% without. There association between score (p=0.23) nor (p = 0.37). ROC analysis MME categories 0-200, 200-500, >500 yielded area under curve 0.74 0.78 VAS. <200 MME, 35.7% (p=0.03) less likely achieve PASS. For every 100 prescribed, decreased by 0.11 (p=0.001) increased 0.018 (p<0.001). probability 1.8% (p=0.004). Conclusions: is risk factor diminished clinical higher following early setting. profile modified total as associated ASES, VAS, likelihood ASES. threshold values 200 500 negatively worsened degrees. Patients increasing should be counseled levels may occur