Arthroscopy The Journal of Arthroscopic and Related Surgery · 2020 · 14 citations · 12 references
MedicineOrthopaedic SurgeryOrthopedic SurgeryOrthopedicsPain ManagementPain MedicineDrug Utilization EvaluationOpioid AnalgesicsOpioid ManagementOpioid TherapyPreoperative Medication ManagementPreoperative Risk AssessmentKnee MeniscectomyPostoperative Opioid PrescribingPostoperative Opioid UsePreoperative Pain AssessmentPreoperative Pain ManagementPreoperative Pain PredictorsPrescribing PracticesPrescription Decision-making
PURPOSE: To prospectively observe opioid consumption in patients undergoing knee arthroscopy and to create an evidence-based guideline for opioid prescription. METHODS: This prospective multicenter observational study enrolled patients undergoing outpatient knee arthroscopy for meniscal repair, meniscectomy, or chondroplasty. Patients were provided with a pain journal to record postoperative opioid consumption, Numeric Pain Rating Scale (NPRS) pain scores, and Likert scale satisfaction scores for 1 week postoperatively. State databases were reviewed for additional opioid prescriptions. RESULTS: One hundred patients were included in this study. Patients were prescribed a median of 5 pills (37.5 oral morphine equivalent [OME]). Median postoperative opioid consumption was 0 pills, with a mean of 0.6 pills (4.4 OME), and 74% of patients did not consume any opioid medication postoperatively. All patients consumed ≤5 pills (37.5 OME), and no patient required a refill. Patients reported a mean daily NPRS value of 1.9 out of 10 and a mean Likert score of 4.4 out of 5. CONCLUSION: We found that current opioid prescribing habits exceed the need for postoperative pain management. Overall, all patients consumed ≤5 opioid pills, and 92% of patients discontinued opioids by the second postoperative day. In spite of the low prescription quantity, patients reported high satisfaction rates and low NPRS pain scores and required no refills. Therefore, we recommend that patients undergoing knee arthroscopy are prescribed no more than 5 oxycodone 5-mg pills. LEVEL OF EVIDENCE: II, prospective prognostic cohort investigation.
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Opioid Consumption After Knee Arthroscopy
Robert D. Wojahn, Ljiljana Bogunovic, Robert H. Brophy et al. · Journal of Bone and Joint Surgery · 2018 · 78 citations · Full text