Literature DB >> 34692932

A Prospective Assessment of Opioid Utilization Post-Operatively in Orthopaedic Sports Medicine Surgeries.

John M Capelle1, P Jahnu Reddy1, Andy T Nguyen1, Heidi A Israel1, Christopher Kim1, Scott G Kaar1.   

Abstract

BACKGROUND: The healthcare system is plagued finding the balance between opioid use and abuse. Orthopaedic surgeons are expected to curtail the number of opioids prescribed in order to lower opioid abuse. We sought to prospectively evaluate opioid consumption following a wide range of sports orthopaedic surgical procedures to determine utilization patterns.
METHODS: All patients receiving procedures within a one-year period were consented and then called daily for one week followed by weekly for up to two months or until the patients no longer were taking their opioid medication. We studied the number of opioids patient's took postoperatively and also collected information in regards to the patient and the surgical procedure.
RESULTS: Included were 223 patients with a mean age of 32.9 years (range, 11 to 82). Surgeons prescribed a mean total of 59.5 pills, and patients reported consuming a mean total of 20.9 pills, resulting in a utilization rate of 40%. 94.4% of patients received no education on how to properly dispose of unused opioids. The mean SANE score was 53.9. The mean Pain Catastrophizing Scale score was 15.1. The mean Opioid Risk Tool was 3.3. The procedures were broken down into: 47.5% ligamentous knee repair, 18.4% shoulder arthroscopy/other shoulder, 7.6% meniscus, 7.6% shoulder arthroplasty, 5.4% distal biceps, 4.0% lower leg (ankle/foot/tibia) and 4.0% shoulder ORIF.
CONCLUSION: Over-prescribing opioids after sports orthopaedic surgeries is widespread. In this study, we found that patients are being prescribed 2.48 times greater opioid medications than needed following sports orthopaedic surgical procedures. We recommend surgeons take care when prescribing postoperative pain control and consider customizing their opioid prescriptions on the basis of prior opioid usage, anatomic location and procedure type. We also recommend educating the patients on proper disposal of excess opioids and consider involving pain management for patients likely to require prolonged opioid usage.

Entities:  

Keywords:  Musculoskeletal pain; Narcotic; Opioid consumption; Pain management; Sports medicine

Year:  2021        PMID: 34692932      PMCID: PMC8503755          DOI: 10.22038/abjs.2020.49306.2455

Source DB:  PubMed          Journal:  Arch Bone Jt Surg        ISSN: 2345-461X


  24 in total

Review 1.  Orthopaedic postoperative pain management.

Authors:  Chris Pasero; Margo McCaffery
Journal:  J Perianesth Nurs       Date:  2007-06       Impact factor: 1.084

2.  Quantifying the Epidemic of Prescription Opioid Overdose Deaths.

Authors:  Puja Seth; Rose A Rudd; Rita K Noonan; Tamara M Haegerich
Journal:  Am J Public Health       Date:  2018-04       Impact factor: 9.308

3.  Further validation of an opioid risk assessment tool: the Brief Risk Interview.

Authors:  Ted Jones; Samantha Lookatch; Patricia Grant; Janice McIntyre; Todd Moore
Journal:  J Opioid Manag       Date:  2014 Sep-Oct

4.  Age and sex trends in long-term opioid use in two large American health systems between 2000 and 2005.

Authors:  Stephen M Thielke; Linda Simoni-Wastila; Mark J Edlund; Andrea DeVries; Bradley C Martin; Jennifer B Braden; Ming-Yu Fan; Mark D Sullivan
Journal:  Pain Med       Date:  2009-11-25       Impact factor: 3.750

5.  The problem of pain in old age.

Authors:  Małgorzata Dziechciaż; Luiza Balicka-Adamik; Rafał Filip
Journal:  Ann Agric Environ Med       Date:  2013       Impact factor: 1.447

6.  Pain as the fifth vital sign: exposing the vital need for pain education.

Authors:  Natalia E Morone; Debra K Weiner
Journal:  Clin Ther       Date:  2013-10-18       Impact factor: 3.393

7.  Opioid Consumption After Rotator Cuff Repair.

Authors:  Robert W Westermann; Chris A Anthony; Nic Bedard; Natalie Glass; Matt Bollier; Carolyn M Hettrich; Brian R Wolf
Journal:  Arthroscopy       Date:  2017-05-29       Impact factor: 4.772

Review 8.  Correlation of Single Assessment Numeric Evaluation (SANE) with other Patient Reported Outcome Measures (PROMs).

Authors:  Casey M O'Connor; David Ring
Journal:  Arch Bone Jt Surg       Date:  2019-07

Review 9.  Prescription Opioid Analgesics Commonly Unused After Surgery: A Systematic Review.

Authors:  Mark C Bicket; Jane J Long; Peter J Pronovost; G Caleb Alexander; Christopher L Wu
Journal:  JAMA Surg       Date:  2017-11-01       Impact factor: 14.766

10.  Opioid Use and Storage Patterns by Patients after Hospital Discharge following Surgery.

Authors:  Karsten Bartels; Lena M Mayes; Colleen Dingmann; Kenneth J Bullard; Christian J Hopfer; Ingrid A Binswanger
Journal:  PLoS One       Date:  2016-01-29       Impact factor: 3.240

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