Reduction of Opioid Use After Upper-Extremity Surgery through a Predictive Pain Calculator and Comprehensive Pain...

Area of Science:

• Orthopedic Surgery
• Pain Management
• Pharmacology

Background:

• Opioid prescriptions for outpatient hand and upper-extremity surgeries often exceed actual patient needs.
• This can lead to significant opioid wastage and potential for misuse.

Purpose of the Study:

• To determine opioid wasting and consumption rates after hand and upper-extremity surgeries.
• To develop and implement a patient-specific calculator and multimodal analgesic plan to guide postoperative opioid prescriptions.

Main Methods:

• A prospective study involving two cohorts of patients undergoing hand and upper-extremity surgery at an ambulatory surgery center.
• The first cohort (n=305) served as a control, while the second (n=221) received a new pain control program including a patient-specific opioid calculator.
• Data on opioid use, wastage, and pain control satisfaction were collected via questionnaires and chart review.

Main Results:

• Opioid prescriptions decreased by 63% (32.0 to 11.7 pills/surgery).
• Opioid consumption decreased by 58% (21.7 to 9.3 pills/surgery).
• Opioid wastage decreased by 62% (13.8 to 5.2 pills/surgery).
• Patient satisfaction with pain control and rates of unplanned opioid refills remained unaffected.

Conclusions:

• Implementing a comprehensive pain plan and patient-specific calculator effectively reduces opioid use in ambulatory upper-extremity surgery.
• This strategy optimizes resource utilization and minimizes opioid-related risks without compromising patient-reported pain control.