Prospective Randomized Study Examining Preoperative Opioid Counseling on Postoperative Opioid Consumption after Upper Extremity Surgery
Autor: | Erica Mann, Sage Vincent, Surena Namdari, Asif M. Ilyas, Talia Chapman, Elizabeth Critchlow, Taylor Paskey, Christopher M. Jones, William Kirkpatrick, Sommer Hammoud, Jack Abboudi |
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Rok vydání: | 2020 |
Předmět: |
Counseling
medicine.medical_specialty Opioid consumption Preoperative counseling Upper Extremity 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Prospective randomized study Prospective Studies 030212 general & internal medicine Opioid addiction Surgery Articles Pain Postoperative 030222 orthopedics business.industry Upper extremity surgery United States Analgesics Opioid Opioid Physical therapy Surgery business medicine.drug |
Zdroj: | Hand (N Y) |
ISSN: | 1558-9455 1558-9447 |
Popis: | Background: Rates of opioid addiction and overdose continue to climb in the United States, increasing pressure on prescribers to identify solutions to decrease postoperative opioid consumption. Hand and upper extremity surgeries are high-volume surgeries with a predilection for inadvertent overprescribing. Recent investigations have shown that preoperative opioid counseling may decrease postoperative opioid consumption. In order to test this hypothesis, a prospective randomized trial was undertaken to determine the effect of preoperative opioid counseling on postoperative opioid consumption. Methods: Eligible patients undergoing outpatient upper extremity surgery were randomized to either receive preoperative opioid counseling or to receive no counseling. Surgeons were blinded to their patient’s counseling status. Preoperatively, patient demographics, surgical and prescription details were recorded. Postoperatively, patients’ pain experience including opioid consumption, pain levels, and satisfaction was recorded. Results: There were 131 total patients enrolled, with 62 in the counseling group and 69 in the control group. Patients receiving counseling consumed 11.8 pills compared to 17.4 pills in the control group ( P = .007), which translated to 93.7 Morphine Equivalent Units (MEU) in the counseling group compared to 143.2 MEU in the control group ( P = .01). There was no difference in pain scores at any time point between groups. Among all study patients a total of 3767 opioid pills were prescribed with approximately 50% left unused. Conclusion: Patients receiving preoperative counseling consumed significantly fewer opioids postoperatively. Inadvertant overprescribing remains high. Routine use of preoperative counseling should be implemented along with prescribing fewer opioids overall to prevent overprescribing. |
Databáze: | OpenAIRE |
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