Reduction of Opioid Consumption After Outpatient Orthopaedic Trauma Surgeries Using a Multimodal Pain Protocol
| Autor: | Carrie L. Vuong, Alexandra K. Schwartz, William T. Kent, Paul J. Girard, John J. Finneran, Brendon C. Mitchell, Matthew Y. Siow, Audrey Zanzucchi |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Outpatient surgery Population Cohort Studies Patient satisfaction Outpatients medicine Humans Pain Management Orthopedics and Sports Medicine education Retrospective Studies education.field_of_study Pain Postoperative business.industry Trauma center Evidence-based medicine Analgesics Opioid Orthopedics Ambulatory Surgical Procedures Morphine Physical therapy Surgery business Body mass index medicine.drug Cohort study |
| Zdroj: | The Journal of the American Academy of Orthopaedic Surgeons. 30(3) |
| ISSN: | 1940-5480 |
| Popis: | Because of the dearth of literature in the orthopaedic trauma population, we aimed to analyze how a multimodal pain protocol after outpatient surgery affects opioid consumption, pain scores, and patient satisfaction.This was a cohort study with a historical control at an urban level 1 trauma center. Forty consecutive outpatients were given a peripheral nerve block and a multimodal pain protocol between September 2019 and March 2020 and compared with 70 consecutive preprotocol patients who received a peripheral nerve block and hydrocodone-acetaminophen. The primary outcome was morphine milligram equivalents (MMEs) consumed. Our secondary aims were pain scores and satisfaction.Patients in the protocol were younger (36.45 versus 45.09 years, P = 0.007), butthere was no difference in sex, body mass index, American Society of Anesthesiologists, or surgical duration. There was a 59% reduction in opioids consumed in the first 4 days after surgery (3.83 MME versus 9.29 MME, P0.001). At the postoperative day-14 time point, protocol patients consumed a total of 5.59 MMEs, which is 40% less than just the first 4 days of the preprotocol (P = 0.02). Protocol patients assigned a higher rating of "least pain" on postoperative day 1 (1.24 versus 0.52, P = 0.04) but had higher satisfaction scores on day 1 (9.68 versus 8.54, P0.001) and day 2 (9.66 versus 8.61, P0.001).Implementation of a multimodal pain management protocol after outpatient orthopaedic trauma surgeries reduced opioid consumption by50% in the first 4 days postoperatively. Additional studies are needed to refine the multimodal pain protocol used in this study.II. |
| Databáze: | OpenAIRE |
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