September 01, 2017
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Researchers of TKA study call for avoidance of excessive opioid prescriptions

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Results from this study indicated large opioid prescriptions should be avoided because the numbers of refills were not reduced and due to risk of abuse.

“The quantity of opioids prescribed after TKA varied widely, ranging from a total [morphine-equivalent dose] MED of 273 [mg] to 3250 mg,” researchers wrote. “The refill rate did not differ between large prescriptions (1400 mg) and smaller prescriptions. Excessive opioid prescriptions should be avoided as they did not decrease the number of refills and pose the risk of divergence and subsequent abuse.”

Researchers performed a retrospective review of 105 primary total knee arthroplasties. The average follow-up was 2.4 years. At 2 weeks and 5 weeks, residents or midlevel providers called patients to discuss their opioid use, weaning from prescribed opioids and issues with surgery. Investigators collected data about opioid refills, Knee Society score (KSS), total morphine-equivalent dose and daily morphine-equivalent dose prescribed.

Results showed oxycodone, hydromorphone and hydrocodone/acetaminophen were the most common narcotics that patients had at discharge. On average, 1,405 mg of total morphine-equivalent dose was prescribed. Investigators noted no difference in the total prescribed morphine-equivalent dose, daily prescribed morphine-equivalent dose or preoperative KSS among patients who needed refills. – by Monica Jaramillo

 

Disclosures: Hernandez reports no relevant financial disclosures. Please see the full study for a list of all other author’s relevant financial disclosures.