Most patients consumed no more than five opioid pills after knee arthroscopy
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Most patients who underwent knee arthroscopy consumed no more than five opioid pills postoperatively, according to published results.
Paul M. Sethi, MD, and colleagues queried 100 patients who underwent knee arthroscopy between May 2018 and May 2019 on total postoperative opioid consumption, preoperative opioid consumption, smoking status and history of depression. Researchers determined the total number of opioids prescribed and number of refills according to each patient’s chart, and reviewed state databases for additional opioid prescriptions.
Results showed a median of five oxycodone 5-mg pills were prescribed to patients postoperatively. Researchers found patients had a median postoperative opioid consumption of zero pills and a mean of 1.9 pills. Patients consumed between zero to 25 pills of oxycodone 5 mg, according to results.
Researchers noted 97% of patients did not obtain refills. Results showed 58% of patients did not consume any opioids and 90% of all patients consumed less than five pills. Sethi noted the results of this study are in contrast to expert panel guidelines that recommend prescription of 12 to 30 opioid pills. Smoking, depression and prior opioid use did not affect postoperative opioid consumption, according to results.
“Orthopedic surgeons need to continue to lead the charge on reducing opiate dependence after surgery,” Sethi told Healio Orthopedics. “This reduction in medication prescribed can translate directly in fewer excess medications prescribed and reduces the risk of misused or diverted medication.” – by Casey Tingle
Disclosures: Sethi reports he is a consultant for Pacira Pharmaceuticals, Arthrex and Flexion Therapeutics; and is an assistant editor for the Journal of Shoulder and Elbow Surgery. Please see the study for all other authors’ relevant financial disclosures.
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Jourdan M. Cancienne, MD
Parth M. Kamdar, BS, and colleagues performed a well-executed retrospective review of postoperative opioid consumption habits in 100 patients who underwent simple knee arthroscopic procedures. The group found that 90% of patients consumed five or fewer oxycodone 5-mg pills postoperatively, and 58% of patients consumed zero pills. The major limitations of the study include its retrospective design and high probability of response and recall bias, in addition to a lack of patient-reported satisfaction levels.
This study is a meaningful addition to a growing body of literature focusing on orthopedists’ opioid-prescribing practices and patients’ consumption postoperatively. Despite being the third leading prescriber of opioids, evidence-based literature to safely and effectively control patients postoperative pain following some of our most common procedures is lacking. Furthermore, in contrast to available expert panel guidelines, and based on their results, Kamdar and colleagues recommend that five oxycodone 5-mg pills serve as the guideline for opioid prescriptions following simple knee arthroscopy. Future research should continue to focus on implementing multimodal pain control strategies to minimize postoperative opioid use while optimizing clinical outcomes and patient satisfaction.
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