Self-Reported Pain Tolerance and Opioid Pain Medication Use After Foot and Ankle Surgery

Area of Science:

• Orthopaedic Surgery
• Pain Management
• Patient Outcomes

Background:

• Opioid use after surgery poses risks; effective pain management is crucial.
• Patient pain tolerance is often used to predict postoperative pain and analgesic needs.
• The direct relationship between pain tolerance and opioid consumption post-surgery has not been extensively studied.

Purpose of the Study:

• To investigate the association between self-reported pain tolerance and prescription opioid usage in patients undergoing foot and ankle surgery.
• To determine if preoperative pain threshold predicts postoperative opioid consumption.

Main Methods:

• Retrospective analysis of a prospective cohort of adult patients undergoing outpatient foot and ankle surgery.
• Collected data on patient demographics, dispensed and consumed opioid pills.
• Assessed pain tolerance using both qualitative and quantitative measures at a mean of 13.1 months postoperatively.

Main Results:

• Higher quantitative and qualitative pain tolerance scores were associated with lower postoperative opioid consumption (P = .047 and P = .005, respectively).
• Multivariate analysis indicated a significant association between higher qualitative pain threshold and reduced opioid consumption (P = .005).
• Qualitative pain threshold did not independently predict the top quartile of opioid pill consumers.

Conclusions:

• Preoperative assessment of both qualitative and quantitative pain threshold can aid surgeons in customizing postoperative pain management.
• Incorporating pain tolerance assessment offers an opportunity to educate patients on responsible opioid use.