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Rothman Opioid Foundation


Prescribing strategies

The latest research on pain management



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Prescribing strategies

Prescribing Strategies
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The authors, Alter & Ilyas, identified that formal pre-operative opioid counseling resulted in two-thirds voluntary decrease in post-operative opioid use after a common hand surgery, carpal tunnel release surgery.


J Hand Surg Am​. 2017 Oct;42(10):810-815.

The authors, Labrum & Ilyas, present evidenced-based pain management strategies for Orthopaedic Surgeons and patients.

JBJS Rev​. 2017 Aug;5(8):e14.


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The authors, Kim & Ilyas et al, report their experience with prescribing opioids after nearly 1500 orthopaedic procedures of the upper extremity and found that two-thirds of opioids go unused. 

J Bone Joint Surg Am​. 2016 Oct 19;98(20):e89.

The authors, Secrist et al, review the pain management strategies and provide evidenced-based guidance for opioid prescribing after Knee ACL Surgery.

Am J Sports Med​.  2016 Sep;44(9):2435-47.

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The authors, Cheesman & Austin et al, found in their prospective randomized trial of Shoulder Rotator Cuff Repair surgery that pre-operative counseling decreased the risk of prolonged post-operative opioid use.

J Shoulder Elbow Surg​. 2020 Sep;29(9):1743-1750.

The authors, Saini & Daniel et al, report their experience with prescribing opioids after nearly 1000 orthopaedic procedures of the lower extremity and found that about half of prescribed opioids go unused. 

Foot Ankle Int​.  2018 Nov;39(11):1257-1265.

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The authors, Ilyas & Matzon et al, performed a prospective randomized double-blinded trial and found that opioids are not routinely needed after common Hand Surgeries. Rather, Tylenol and Motrin were equally effective in treating associated post-operative pain. 

Orthopedics​. 2019 Mar 1;42(2):110-115

The authors, Adalbert & Ilyas, demonstrate that an evidenced-based opioid sparing post-operative prescribing strategy is effective after Hand Surgery.

Hand (N Y)​. 2019 Aug 23;1558944719867122

preop opioid counseling upper extrem sur
preop opioid counseling upper extrem sur

The authors, Vincent & Ilyas et al, found that pre-operative opioid counseling decreased voluntary post-operative opioid usage by almost half. 

Hand (N Y)​. 2020 May 20;1558944720919936.

The authors, Alter et al, found that the use of a long-acting local anesthetic, Exparel, injected into the surgical field during wrist fracture surgery decreased pain and opioid use post-operatively.

J Hand Surg Am​. 2017 Dec;42(12):1003-1008.

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The authors, Fleischman et al, demonstrated that the use of a opioid-sparing "multi-modal"post-operative pain management strategy after Total Hip Replacement surgery decreased patients pain experience, opioid need, refill requests; all while also increasing patient satisfaction.

J Am Coll Surg​. 2019 Oct;229(4):335-345.e5.

The authors, Labrum & Ilyas, found that injecting the surgical site with a local anesthetic resulted in decreased post-operative pain and opioid use.

J Hand Microsurg​. 2017 Aug;9(2):80-83.

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Prospective Evaluation of Utilization Patterns and Prescribing Guidelines of Opioid Consumption Following Orthopedic Foot and Ankle Surgery

Foot Ankle Int​. 2018 Nov;39(11):1257-1265.

The authors, McDonald & Winters et al, found that the use of intravenous Toradol (an NSAID) was given during ankle fracture surgery that it decreased post-operative pain and opioid use.

Clin Orthop Relat Res​. 2020 Jan;478(1):144-151.

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The authors, Hannon et al, performed a systematic review of pain management after total hip and knee replacement surgery and found that the opioids post-operatively should be used cautiously due to its moderate effectiveness but high complication rate.

J Arthroplasty​. 2020 Oct;35(10):2759-2771.e13.

The authors, Miller & Ilyas et al, examined the effectiveness of local use versus regional use of local anesthetics during hand surgery and found that both decreased post-operative pain and opioid use, but one was not necessarily superior to another.

Orthopedics​. 2018 May 1;41(3):e410-e415.

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Prospective Randomized Study Examining Preoperative Opioid Counseling on Postoperative Opioid Consumption after Upper Extremity Surgery

Hand (N Y)​.  2020 May 20;1558944720919936.

How Patients Dispose of Unused Prescription Opioids: A Survey of over 300 Postoperative Patients

Cureus​ 2022 Aug 17;14(8):e28111.

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Multiple Opioid Prescribers During the Perioperative Period Increases Opioid Consumption Following Upper Extremity Surgery: A Multicenter Analysis

Cureus. 2022 Apr 27;14(4):e24541. 

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understanding opioid use after total hip

Understanding Opioid Use After Total Hip Arthroplasty: A Comprehensive Analysis of a Mandatory Prescription Drug Monitoring Program

J Am Acad Orthop Surg​.  2020 Oct 15;28(20):e917-e922.

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