What is the required Morphine Milligram Equivalent (MME) for shoulder surgery?

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The morphine milligram equivalent (MME) required for shoulder surgery can be as low as 78 MME, with an initial prescription of 7 5-mg oxycodone pills, which is associated with less maximum possible opioid consumption without an increase in refill requests or office contacts for pain-related concerns, as shown in the most recent study 1. This approach is supported by the study published in 2024, which found that an initial prescription of fewer opioid pills was associated with less maximum possible opioid consumption without compromising pain control or increasing the need for refills or office visits 1. The use of multimodal analgesia, including scheduled acetaminophen and NSAIDs, can help minimize opioid consumption and reduce the risk of adverse effects, as suggested by previous studies 2, 3, 4, 5. Key factors to consider when determining the MME requirement for shoulder surgery include patient factors such as prior opioid exposure, age, and pain tolerance, as well as the type of surgery being performed. Some studies have reported varying MME requirements, ranging from 50-100 MME per day for 3-5 days postoperatively, but the most recent and highest-quality study 1 suggests that a lower initial prescription can be effective and safe. It is essential to prioritize multimodal analgesia and minimize opioid consumption to reduce the risk of respiratory depression, constipation, and dependence, which are significant concerns in the context of the current opioid epidemic. By adopting a more conservative approach to opioid prescribing, as supported by the latest evidence 1, clinicians can help reduce the risk of opioid-related adverse effects while still providing effective pain management for patients undergoing shoulder surgery.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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