A Prospective Evaluation of Opioid Utilization After Upper-Extremity Surgical Procedures: Identifying Consumption...

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Postoperative pain management is crucial, but opioid overprescribing can lead to community diversion.
• Evaluating opioid consumption patterns is key to responsible prescribing.

Purpose of the Study:

• To prospectively assess opioid utilization after outpatient upper-extremity surgery.
• To establish evidence-based opioid prescribing guidelines.

Main Methods:

• Prospective data collection on 1,416 patients undergoing outpatient upper-extremity surgery.
• Analysis included patient demographics, surgical details, anesthesia, and opioid prescription/consumption.
• Statistical analysis used ANOVA and t tests with Bonferroni correction.

Main Results:

• Patients consumed 34% of prescribed opioids (8.1/24 pills).
• Opioid needs varied significantly by procedure type (soft tissue, fracture, joint) and anatomic location (hand, wrist, arm, shoulder).
• Procedure type, location, anesthesia, age, and insurance were associated with consumption.

Conclusions:

• Patients are prescribed roughly three times the opioid medication needed for upper-extremity procedures.
• Surgeons should customize prescriptions based on procedure and location to optimize opioid use.
• Reducing excess opioid prescriptions can prevent community diversion.