Standardized Perioperative Patient Education Decreases Opioid Use after Hand Surgery: A Randomized Controlled Trial.

Autor:	Stepan JG; From the University of Chicago, Department or Orthopaedic Surgery and Rehabilitation Medicine; Departments of Orthopedic Surgery and Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; and Weill Cornell Medicine., Sacks HA; From the University of Chicago, Department or Orthopaedic Surgery and Rehabilitation Medicine; Departments of Orthopedic Surgery and Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; and Weill Cornell Medicine., Verret CI; From the University of Chicago, Department or Orthopaedic Surgery and Rehabilitation Medicine; Departments of Orthopedic Surgery and Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; and Weill Cornell Medicine., Wessel LE; From the University of Chicago, Department or Orthopaedic Surgery and Rehabilitation Medicine; Departments of Orthopedic Surgery and Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; and Weill Cornell Medicine., Kumar K; From the University of Chicago, Department or Orthopaedic Surgery and Rehabilitation Medicine; Departments of Orthopedic Surgery and Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; and Weill Cornell Medicine., Fufa DT; From the University of Chicago, Department or Orthopaedic Surgery and Rehabilitation Medicine; Departments of Orthopedic Surgery and Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery; and Weill Cornell Medicine.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2021 Feb 01; Vol. 147 (2), pp. 409-418.
DOI:	10.1097/PRS.0000000000007574
Abstrakt:	Background: Despite the growing hand surgery literature on postoperative opioid use, there is little research focused on patient-centered interventions. The purpose of this randomized controlled trial was to create a standardized patient education program regarding postoperative pain management after hand surgery and to determine whether that education program would decrease postoperative opioid use. Methods: Patients scheduled to undergo ambulatory hand surgery were recruited and randomized to standardized pain management education or standard of care. All patients received a webinar with instructions for study participation, whereas the education group received an additional 10 minutes of education on postoperative pain management. All patients completed a postoperative daily log documenting opioid consumption. The total number of opioid pills consumed was compared between groups. The authors constructed a linear regression model to determine risk factors for postoperative opioid use after surgery. Results: A total of 267 patients were enrolled in the study. One hundred ninety-one patients completed the study (standardized education, n = 93; control group, n = 97). Patients in the standardized education group were more likely to take no opioid medication (42 percent versus 25 percent; p = 0.01) and took significantly fewer opioid pills (median, two) than those in the control group (median, five) (p < 0.001). Standardized education predicted decreased postoperative opioid pill consumption, whereas higher number of pills prescribed and a history of psychiatric illness were risk factors for increasing opioid use. Conclusion: Perioperative patient education and limitation of postoperative opioid prescription sizes reduced postoperative opioid use following ambulatory hand surgery. Clinical Question/level of Evidence: Therapeutic, II. Competing Interests: Disclosure:Each author certifies that he or she has no commercial associations that might pose a conflict of interest in connection with the submitted article. (Copyright © 2020 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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