Opioid-sparing protocol may reduce opioid consumption after shoulder, knee arthroscopy
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Key takeaways:
- The opioid-sparing group consumed significantly less opioids postoperatively vs. the standard-of-care group.
- The standard-of-care group had a nonsignificant trend toward higher rates of refill requests.
LAS VEGAS — Results showed implementation of an opioid-sparing pain management protocol may reduce opioid consumption compared with a standard opioid prescription protocol in patients undergoing outpatient shoulder and knee arthroscopy.
“This study strongly suggests that patients may not require opioid pain management, not just for simple debridements or meniscectomies, but even for potentially more complex procedures, like ACL reconstructions and rotator cuff repairs,” Nolan S. Horner, MD, an orthopedic surgeon in Chicago, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Horner and colleagues randomly assigned patients undergoing arthroscopic shoulder or knee surgery to either a nonopioid or minimal opioid, pain management protocol group (n=100) or a standard-of-care group (n=100). Horner noted the opioid-sparing group received an educational infographic explaining how to manage pain after surgery, a standardized nonopioid pain prescription and a limited rescue opioid prescription to use in case of breakthrough pain, while the standard-of-care group received an opioid prescription based on the surgeon’s discretion.
“Our primary outcome was the amount of opioids consumed up to 6 weeks, but we also compared things like patient’s pain control with VAS score during the initial 2- and 6-week periods and their satisfaction with their pain control even after the opioid refills that they required,” Horner said.
Patients in the opioid-sparing group consumed significantly less postoperative opioids vs. the standard-of-care group, according to Horner. He added the two groups had no significant differences in VAS scores or satisfaction.
“There was a nonsignificant trend toward higher rates of refill requests in the group that had initially been prescribed the standard prescription, there were significantly higher rates of medication side effects and there was no difference in postoperative adverse events,” Horner said.
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Horner NS, et al. Paper 242. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 7-11, 2023; Las Vegas.
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