The Relationship Between Shoulder Intra-Articular Joint Pressure Change, Operative Variables, Early Postoperative Pain and Opioid Consumption: A Pilot Study

TL;DR

This pilot study explores how changes in shoulder joint pressure during surgery relate to postoperative pain and opioid use.

Contribution

The study is the first to link intra-articular pressure changes during shoulder arthroscopy to postoperative pain and opioid consumption.

Findings

Increased joint pressure change correlated with higher opioid consumption (r = 0.30; P = 0.02).

Smaller joint pressure changes were associated with reduced postoperative pain (r = -0.23; P = 0.047).

Maintaining low joint pressure may reduce postoperative pain and opioid use.

Abstract

Introduction: This pilot study evaluated the relationship between intra-articular joint pressure changes and fluid volume during shoulder arthroscopy, relating these to postoperative pain and opioid consumption.

Methods: Fifty-two patients who underwent shoulder arthroscopic procedures were included. Measurements of joint pressure, fluid volume utilized, and postoperative opioid intake were recorded. Pain levels were assessed using the visual analog scale preoperatively and one week postoperatively. Pressure change was measured as postoperative minus preoperative intra-articular pressure.

Results: Initial mean joint pressure was 4.63 mm Hg, increasing to a mean of 33.9 mm Hg postoperatively. A negative correlation was observed between increased joint pressure change and visual analog scale delta (r = -0.23; P = 0.047), along with a positive correlation between increased joint pressure change and morphine milligram equivalents of opioids (r = 0.30; P = 0.02).

Conclusion: This exploratory study demonstrates that smaller changes in joint pressure correlate with a decrease in postoperative pain. Conversely, an increase in joint pressure was associated with heightened opioid consumption, demonstrating that maintaining low pressure can provide possible benefits with a decrease in postoperative pain and opioid consumption.