The Effect of Pre-Operative Opioid Education on Post-Operative Opioid Consumption after Outpatient Orthopaedic Surgery: Prospective Randomized Trial
Asif M. Ilyas, MD, MBA
Talia Chapman, MD
Benjamin Zmistowski, MD
Kristin Sandrowski, MD
Jack Graham, MD
Sommer Hammoud, MD
Postoperative pain management and opioid consumption following outpatient orthopaedic surgery may be influenced by a number of variables including knowledge of safe opioid use. A prospective randomized study was undertaken to understand the effect of preoperative opioid counseling on postoperative opioid consumption following outpatient orthopaedic surgeries.
A total of 237 patients undergoing outpatient orthopaedic surgeries were prospectively randomized to receive preoperative opioid counseling or not. Postoperative data collected included the number of pills taken, daily visual analog scale (VAS) pain scores, adverse events, and attitude toward their pain experience.
A total of 107 patients were randomized to receive preoperative counseling and 130 were not counseled. On average, 27 pills were prescribed to each patient. The preoperative opioid counseling group consumed significantly less opioids (6 pills) when compared to the group not receiving counseling (12 pills) (p < 0.05). The findings were the same with upper and lower extremity surgeries. Overall, patients in either group had similar daily VAS ratings, and were satisfied with their postoperative pain experience irrespective of opioid counseling. Of the total opioid pills prescribed during the study, only 46% were ultimately consumed.
Preoperative counseling significantly reduced the number of prescription opioid pills and total morphine equivalents consumed by patients in the postoperative period following outpatient orthopaedic surgery without any negative effects on pain experience. This finding was consistent in both upper and lower extremity surgery. Approximately twice the number of opioids were prescribed than ultimately consumed by patients.
RESEARCH ABSTRACT PRESENTED at the 2021 ANNUAL MEETING of the: