Multimodal analgesic strategy found effective for reducing opioid use after trauma surgery
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Compared with an original, pill-based multimodal pain regimen, a generic multimodal analgesic strategy in trauma was more effective for managing pain and reducing opioid exposure after trauma surgery, according to published results.
In a 12-month period, researchers from the University of Texas Health Science Center in Houston analyzed the outcomes of 1,561 orthopedic trauma patients to compare the institution’s original, pill-based multimodal pain regimen (MMPR) with a generic multimodal analgesic strategy in trauma (MAST) MMPR. Outcome measures included mean reported pain scores and oral morphine milligram equivalents (MME) during hospitalization and at discharge.
According to the study, the original MMPR consisted of IV and oral acetaminophen, 48 hours of celecoxib and pregabalin followed by naproxen and gabapentin, scheduled tramadol and oxycodone for breakthrough pain. The MAST MMPR consisted of oral acetaminophen, naproxen, gabapentin, lidocaine patches and opioids as need.
Patients in the MAST MMPR cohort (n = 774) had a daily opioid use of 34 MME and 62% were prescribed opioids at discharge. Comparatively, patients in the original MMPR cohort (n = 787) had a daily opioid use of 48 MME and 67% were prescribed opioids at discharge. No differences in pain scores were seen, the authors wrote in the study.
“The MAST MMPR reduced opioid exposure and discharge from the hospital with an opioid prescription while achieving similar pain control after trauma,” the authors added. “These findings underscore the efficacy of opioid-minimizing strategies after trauma and the MAST MMPR has become usual practice for injured patients admitted to our trauma center.”
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