Preinjury Narcotic Use Does Not Affect Treatment for Compartment Syndrome

Area of Science:

• Trauma Surgery
• Orthopedic Surgery
• Pain Management

Background:

• Opioid use is prevalent in trauma patients.
• The impact of preinjury opioid use on the diagnosis of compartment syndrome is not well understood.

Purpose of the Study:

• To investigate the association between preinjury opioid use and the incidence of fasciotomy in patients with lower extremity trauma.

Main Methods:

• Retrospective case-control study at a Level 1 trauma center.
• Included patients with lower extremity compartment syndrome requiring fasciotomy and matched controls with tibial fractures not requiring fasciotomy.
• Analyzed demographics, injury characteristics, and preinjury opioid use (rate and morphine milligram equivalents/day).

Main Results:

• No significant difference in chronic or active preinjury opioid use between patients requiring fasciotomy and controls.
• No significant difference in average daily morphine milligram equivalents (MME) for opioid users in either group.
• Odds ratios for fasciotomy were not significantly different between opioid users and non-users.

Conclusions:

• Preinjury opioid use does not influence the rate of fasciotomy for lower extremity compartment syndrome.
• Findings suggest that pre-existing opioid use does not impair the accurate diagnosis of compartment syndrome in trauma patients.
• The diagnosis and treatment of compartment syndrome are not negatively affected by preinjury narcotic use.