Beware the rebound effect: regional anesthesia increases opioid utilization after humerus fracture surgery.
| Autor: | Cunningham DJ; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, USA., LaRose MA; Duke University School of Medicine, Duke University Medical Center, Durham, USA., Zhang GX; Duke University School of Medicine, Duke University Medical Center, Durham, USA., Paniagua AR; Duke University School of Medicine, Duke University Medical Center, Durham, USA., Klifto CS; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, USA., Gage MJ; Department of Orthopaedic Surgery, Duke University Medical Center, Durham, USA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Shoulder & elbow [Shoulder Elbow] 2022 Dec; Vol. 14 (6), pp. 648-656. Date of Electronic Publication: 2021 Oct 26. |
| DOI: | 10.1177/17585732211048117 |
| Abstrakt: | Introduction: Regional anesthesia (RA) is used reduce pain in proximal humerus and humeral shaft fracture surgery. The study hypothesis was that RA would decrease opioid demand in patients undergoing fracture surgery. Materials and Methods: Opioid demand was recorded in all patients ages 18 and older undergoing proximal humerus or humeral shaft fracture surgery at a single, Level I trauma center from 7/2013 - 7/2018 (n = 380 patients). Inpatient opioid consumption from 0-24, 24-48, and 48-72 h and outpatient opioid demand from 1-month pre-operative to 90-days post-operative were converted to oxycodone 5-mg equivalents (OE's). Unadjusted and adjusted models were constructed to evaluate the impact of RA and other factors on opioid utilization. Results: Adjusted models demonstrated increases in inpatient opioid consumption in patients with RA (6.8 estimated OE's without RA vs 8.8 estimated OE's with RA from 0-24 h post-op; 10 vs 13.7 from 24-48 h post-op; and 8.7 vs 11.6 from 48-72 h post-op; all p < 0.05). Estimated cumulative outpatient opioid demand was significantly higher in patients with RA at all timepoints. Discussion: In proximal humerus and humeral shaft fracture surgery, RA was associated with increased inpatient and outpatient opioid demand after adjusting for baseline patient and treatment characteristics. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2021.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|