Postoperative consumption of opioids over six weeks reduced with multimodal opioid-sparing protocol for managing pain following arthroscopic shoulder or knee surgery
MONDAY, Oct. 17, 2022 (HealthDay News) — An opioid-sparing postoperative pain management protocol reduces opioid consumption compared with standard care for patients undergoing outpatient shoulder or knee arthroscopy, according to a study published in the Oct. 4 issue of the Journal of the American Medical Association.
Aaron Gazendam, M.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a randomized clinical trial to examine the effect of a multimodal, opioid-sparing approach to postoperative pain management versus standard care for 200 patients undergoing arthroscopic shoulder or knee surgery. The opioid-sparing group (100 participants) received a prescription of naproxen, acetaminophen, and pantoprazole; a limited rescue prescription for hydromorphone; and a patient education infographic. The control group (100 participants) received the current standard of care opioid analgesic, as determined by the treating surgeon.
The researchers found that compared with the control group, patients in the opioid-sparing group consumed significantly fewer opioids (median, 0 versus 40.0 mg). Four of the five prespecified secondary end points showed no significant difference between the groups. The amount of oral morphine equivalents prescribed was 341.2 and 40.4 mg in the standard-care and opioid-sparing groups, respectively. At six weeks, there was no significant difference seen in adverse events (2.1 and 3.2 percent in the standard-care and opioid-sparing groups, respectively), but more patients in the standard-care group reported medication-related adverse effects (32 versus 19 percent).
“An opioid-sparing postoperative pain management protocol significantly reduced postoperative opioid consumption compared with a standard opioid prescription in the six weeks following surgery,” the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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