PURPOSE: To determine whether postoperative acetaminophen reduced narcotic consumption following hip arthroscopy for femoroacetabular impingement. METHODS: This was a single-center randomized controlled trial. Opioid-naïve patients undergoing hip arthroscopy for femoroacetabular impingement were randomized into 2 groups. The control group received our institution's standard of care for postoperative pain control, 28 tablets of 5 mg/325 mg oxycodone-acetaminophen prescribed as 1 to 2 tablets every 6 hours as needed for pain, whereas the treatment group were prescribed 650 mg acetaminophen every 6 hours for pain, with 5 mg/325 mg oxycodone-acetaminophen prescribed for breakthrough pain. Patients were instructed to be mindful of taking no more than 3 g of acetaminophen in a 24-hour limit. If this limit was reached, oxycodone 5 mg would be prescribed. They were contacted daily and asked to report opioid use as well as their level of pain using the visual analog pain scale. RESULTS:Our institution enrolled 86 patients, 80 of whom completed the study (40 control, 40 treatment). There were no statistically significant differences with respect to patient demographics and patient-specific factors between groups (age at time of surgery, sex, American Society of Anesthesiologists classification, or body mass index). In addition, there was no statistically significant difference with respect to visual analog scale pain between groups preoperatively (P = .64) or at 1-week follow up (P = .39). The treatment group did not use a statistically significant different number of narcotics than the control group throughout the first postoperative week (6.325 pills treatment vs 5.688 pills control, P = .237). CONCLUSIONS: The findings of this randomized controlled trial suggest that postoperative acetaminophen may have no effect on reducing the number of narcotic pills consumed by opioid-naïve patients following hip arthroscopy in the setting of reduced opioid-prescribing on the part of orthopaedic surgeons. Furthermore, the results of this study suggest surgeons may reduce postoperative narcotic prescribing without reducing patient satisfaction following hip arthroscopy. LEVEL OF EVIDENCE: II randomized control trial.
RCT Entities:
PURPOSE: To determine whether postoperative acetaminophen reduced narcotic consumption following hip arthroscopy for femoroacetabular impingement. METHODS: This was a single-center randomized controlled trial. Opioid-naïve patients undergoing hip arthroscopy for femoroacetabular impingement were randomized into 2 groups. The control group received our institution's standard of care for postoperative pain control, 28 tablets of 5 mg/325 mg oxycodone-acetaminophen prescribed as 1 to 2 tablets every 6 hours as needed for pain, whereas the treatment group were prescribed 650 mg acetaminophen every 6 hours for pain, with 5 mg/325 mg oxycodone-acetaminophen prescribed for breakthrough pain. Patients were instructed to be mindful of taking no more than 3 g of acetaminophen in a 24-hour limit. If this limit was reached, oxycodone 5 mg would be prescribed. They were contacted daily and asked to report opioid use as well as their level of pain using the visual analog pain scale. RESULTS: Our institution enrolled 86 patients, 80 of whom completed the study (40 control, 40 treatment). There were no statistically significant differences with respect to patient demographics and patient-specific factors between groups (age at time of surgery, sex, American Society of Anesthesiologists classification, or body mass index). In addition, there was no statistically significant difference with respect to visual analog scale pain between groups preoperatively (P = .64) or at 1-week follow up (P = .39). The treatment group did not use a statistically significant different number of narcotics than the control group throughout the first postoperative week (6.325 pills treatment vs 5.688 pills control, P = .237). CONCLUSIONS: The findings of this randomized controlled trial suggest that postoperative acetaminophen may have no effect on reducing the number of narcotic pills consumed by opioid-naïve patients following hip arthroscopy in the setting of reduced opioid-prescribing on the part of orthopaedic surgeons. Furthermore, the results of this study suggest surgeons may reduce postoperative narcotic prescribing without reducing patient satisfaction following hip arthroscopy. LEVEL OF EVIDENCE: II randomized control trial.
Authors: David A Bloom; Daniel J Kaplan; David J Kirby; Daniel B Buchalter; Charles C Lin; Jordan W Fried; Nainisha Chintalapudi; Thomas Youm Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-11-05 Impact factor: 4.342