Multimodal pain regimen improved satisfaction after outpatient hand surgery vs. opioids
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Key takeaways:
- A multimodal postoperative pain regimen increased satisfaction for patients undergoing hand and wrist surgery vs. a traditional opioid regimen.
- Daily pain scores were similar between the groups.
Compared with a traditional postoperative opioid regimen, a multimodal pain management regimen increased satisfaction for patients who underwent outpatient orthopedic hand or wrist surgery, according to published results.
Asif M. Ilyas, MD, MBA, FACS, and colleagues from the Rothman Orthopaedic Institute at Thomas Jefferson University randomly assigned 112 consecutive patients who underwent outpatient orthopedic hand or wrist surgery to receive either a traditional opioid pain management regimen (n = 54) or a multimodal pain management regimen (n = 58) after surgery. The opioid group received oxycodone to be taken as needed, while the multimodal group received oral acetaminophen and naproxen, as well as oxycodone to be taken as needed. Outcomes included daily pain levels, medication usage, refills, patient satisfaction and complications.
The most common procedures included open reduction and internal fixation of a distal radius fracture (n = 43), carpal tunnel release (n = 19) and medial or lateral epicondylitis debridement (n = 11).
Overall, Ilyas and colleagues found the two groups had similar daily average pain scores and daily worst pain scores. Patients in the multimodal group took fewer average daily oxycodone pills vs. the opioid group (0.24 pills vs. 0.79 pills, respectively) and fewer total oxycodone pills (2.41 pills vs. 6.96 pills, respectively). In addition, patients in the multimodal group reported significantly fewer refills vs. the opioid group (10.7% vs. 21.4%, respectively).
According to the study, 66% of patients in the multimodal group and 42% of patients in the opioid group were satisfied with their pain control.
“The presence of increased satisfaction, decreased side effects and fewer opioids used among our study group suggests the immense benefits a multimodal regimen has for orthopedic patients undergoing hand and wrist procedures,” Ilyas and colleagues wrote in the study.
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