Article
Orthopedics
E. Bailey Terhune, Charles P. Hannon, Robert A. Burnett, Craig J. Della Valle
Summary: Preoperative opioid use is associated with an increase in postoperative complications after TKA, with the risk increasing in a dose-dependent manner. Higher doses of opioids are linked to a greater risk of prosthetic joint infection and revision surgery.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Surgery
Kevin K. Zhang, Kevin M. Blum, Jacqueline J. Chu, Abeba Zewdu, Sarah Janse, Roman Skoracki, Jeffrey E. Janis, Jenny C. Barker
Summary: This study tested the efficacy of a patient-specific opioid prescribing framework for estimating postdischarge opioid consumption and found that it accurately estimates opioid need and risk of persistent use in plastic surgery patients.
PLASTIC AND RECONSTRUCTIVE SURGERY
(2023)
Article
Anesthesiology
Chris A. Rishel, Martin S. Angst, Eric C. Sun
Summary: The study found that changes in preoperative opioid utilization were not clinically significant for several postoperative outcomes, with patients who gradually decreased opioid utilization having lower postoperative opioid usage and patients who gradually increased usage having slightly lower usage.
Article
Anesthesiology
Gavin M. Hamilton, Sarah Tierney, Reva Ramlogan, Colin J. L. McCartney, Lisa A. Bromley, Daniel I. McIsaac
Summary: This retrospective analysis did not find an association between receipt of a peripheral nerve block and a lower incidence of persistent postoperative opioid prescription fulfillment in ambulatory shoulder surgery patients.
Article
Pediatrics
Kerwyn Jones, Laurie Engler, Elizabeth Fonte, Ibrahim Farid, Michael T. Bigham
Summary: The creation and implementation of standardized pain prescribing guidelines for pediatric patients after orthopedic surgical procedures led to a significant reduction in opioid prescriptions while maintaining effective pain management. Compliance with the guidelines exceeded 90% and there was a sustained 54% reduction in opioids prescribed post-intervention for 12 months. The percentage of unanticipated opioid prescription refills remained stable at 3% before and after the guidelines were implemented.
Article
Multidisciplinary Sciences
Alban Zammit, Jean Coquet, Jennifer Hah, Oualid el Hajouji, Steven M. Asch, Ian Carroll, Catherine M. Curtin, Tina Hernandez-Boussard
Summary: Surgical patients with diabetes are at increased risk for prolonged opioid use (POU) even after controlling for likely covariates. Therefore, a more tailored approach to postoperative pain management for diabetic patients is warranted.
Article
Clinical Neurology
Chason Ziino, Aditya Karhade, Andrew J. Schoenfeld, Mitchel B. Harris, Joseph H. Schwab
Summary: A minority of patients who underwent lumbar discectomy continue to receive opioid prescriptions up to 15 months after surgery. Many of these prescriptions are written by nonsurgical providers unaffiliated with the operative team. Surgical providers were found to have a lower likelihood of issuing an opioid prescription compared to nonsurgical clinicians.
JOURNAL OF NEUROSURGERY-SPINE
(2021)
Article
Orthopedics
Tejbir S. Pannu, Jesus M. Villa, Jorge Fleites, Preetesh D. Patel, Carlos A. Higuera, Aldo M. Riesgo
Summary: This study aimed to evaluate the impact of Florida's opioid prescription limiting law on opioid prescription and perioperative outcomes after total joint arthroplasty. The results showed a significant decline in opioid prescription without an increase in rates of patient visits, phone calls, or readmission.
JOURNAL OF ARTHROPLASTY
(2021)
Article
Surgery
Brian T. T. Fry, Ryan A. A. Howard, Vidhya Gunaseelan, Jay S. S. Lee, Jennifer F. F. Waljee, Michael J. J. Englesbe, Joceline V. V. Vu
Summary: In a large cohort of patients undergoing common surgical procedures, there was no significant association between opioid prescription size at discharge after surgery and patient satisfaction. This suggests that surgeons can provide smaller opioid prescriptions postoperatively without diminishing patient satisfaction.
Article
Anesthesiology
Eward J. Melis, Johanna E. Vriezekolk, Julian C. C. van der Laan, Jose M. H. Smolders, Bart J. F. van den Bemt, Maaike G. E. Fenten
Summary: This study assessed the prevalence and predictors of long-term postoperative opioid use in an orthopaedic center using online patient reported measures. The results showed that 12.5% of patients used opioids long-term after surgery, with 3.3% being new users. Preoperative opioid use and affected body region were significant predictors of long-term opioid use.
EUROPEAN JOURNAL OF PAIN
(2023)
Review
Orthopedics
Vasil V. Kukushliev, Katherine A. Sherman, Christopher M. Kurylo, Stephen D. Ortmann, Robert A. Scheidt, Karl B. Scheidt
Summary: Overprescription of pain medications contributes to the opioid epidemic and affects veterans significantly. The implementation of an opioid taper protocol resulted in reduced administration of opioids postdischarge. The study suggests that taper protocols should be considered for postoperative pain management.
JOURNAL OF ARTHROPLASTY
(2023)
Review
Oncology
Dario Bugada, Megan Drotar, Simone Finazzi, Giovanni Real, Luca F. Lorini, Patrice Forget
Summary: This systematic review aimed to evaluate the effectiveness of opioid-free anesthesia (OFA) compared to opioid-based anesthesia (OBA) in cancer patients undergoing surgery. Only two eligible studies were found, with significant heterogeneity in outcomes. The results could not confirm or reject the ability of OFA to improve early postoperative outcomes in cancer surgery. More studies are needed with consistent methodology and endpoints.
Article
Orthopedics
Aaron M. M. Gazendam, Michelle Ghert, Kenneth R. R. Gundle, James B. B. Hayden, Yee-Cheen Doung
Summary: This study analyzed opioid consumption patterns in musculoskeletal oncology patients undergoing limb-salvage surgery and endoprosthetic reconstruction. The study found that despite a high prevalence of preoperative opioid use, only a few patients continued to consume opioids at 1 year postoperatively. These results suggest the need for specific prescribing guidelines for musculoskeletal oncology patients.
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
(2023)
Article
Orthopedics
Viktor C. Tollemar, Hsou-Mei Hu, Andrew G. Urquhart, Elizabeth A. Dailey, Brian R. Hallstrom, Mark C. Bicket, Jennifer F. Waljee, Chad M. Brummett
Summary: This study aimed to investigate the association between the size of initial opioid prescription and the likelihood of refill after elective primary total knee and hip arthroplasty. National datasets of insurance claims were retrospectively analyzed, and a cohort of opioid-naive patients who underwent surgery between January 2015 and November 2019 was identified. The refill rate within 30 days after discharge was the primary outcome, and the total amount of opioid filled in the initial prescription was the predictor variable. The results showed that larger initial opioid prescription size was associated with small decreases in 30-day refill rate after total joint arthroplasty, suggesting that concerns about decreasing postsurgical opioid prescribing may not be warranted.
JOURNAL OF ARTHROPLASTY
(2023)
Article
Medicine, General & Internal
Aaron Gazendam, Seper Ekhtiari, Nolan S. Horner, Nicole Simunovic, Moin Khan, Darren L. de Sa, Kim Madden, Olufemi R. Ayeni
Summary: This study evaluates the effectiveness of an opioid-sparing approach in postoperative pain management for arthroscopic shoulder or knee surgery patients, showing a significant reduction in opioid consumption postoperatively.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2022)