Strong opioids do not provide better pain relief vs. mild opioids after fracture surgery
Click Here to Manage Email Alerts
Published results showed use of strong opioids for postdischarge treatment of subacute pain among patients with surgically managed orthopedic fractures was not superior when compared with a milder opioid medication.
Deanne E. Jenkin, PhD, and colleagues randomly assigned 120 patients with one or more acute orthopedic fractures requiring surgical fixation to receive either one or two tablets of oxycodone hydrochloride four times per day (strong opioid group, n = 59) or a combination of acetaminophen and codeine four times per day for a maximum of 3 weeks (mild opioid group, n=61). Researchers considered the mean of daily pain scores collected during week 1 of treatment measured using the Numeric Pain Rating Scale (NPRS) as the primary outcome, while secondary outcomes included EuroQol-5D-5L questionnaire responses, worst pain, medication adverse events, global perceived effect and return to work.
Results showed patients had a mean daily NPRS pain score of 4.04 in the strong opioid group and 4.54 in the mild opioid group from days 1 to 7 postdischarge. Although patients in the strong opioid group had a sixfold increased dose of opioids, researchers found no statistically significant between-group difference of the primary outcome.
“Our randomized trial found that after going home from fracture surgery, strong opioids were not better for pain relief compared to a milder, potentially safer opioid alternative,” Jenkin, of the University of New South Wales in Australia and currently at the Daffodil Centre at the University of Sydney, told Healio Orthopedics. “Clinicians should consider a less-is-more approach to pain management after fracture surgery. It makes good sense to avoid medications that can cause harm if they provide no greater benefits as was the case here — no better pain outcomes for the strong opioid group. Further testing on mild and non-opioid analgesics is needed to inform evidence-based decisions.”
Collapse
Read more about
Click Here to Manage Email Alerts