Regional anesthesia does not decrease inpatient or outpatient opioid demand in femoral shaft fracture surgery.

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Pain Management

Background:

• Regional anesthesia (RA) is considered for pain and opioid reduction in femoral shaft fracture surgery.
• The effect of RA on inpatient and outpatient opioid demand in these patients remains unclear.

Purpose of the Study:

• To assess the impact of RA on inpatient opioid consumption and outpatient opioid demand following femoral shaft fracture surgery.

Main Methods:

• Retrospective cohort study (Level III) of 436 patients undergoing femoral shaft fracture surgery.
• Data collected on inpatient opioid consumption and outpatient opioid demand from 7/2013 - 7/2018.
• Multivariable models analyzed the association between RA and opioid use, adjusting for patient and treatment factors.

Main Results:

• Adjusted models showed increased inpatient opioid consumption between 48-72 hours post-op in patients receiving RA (p<0.05).
• No significant differences in inpatient opioid consumption were observed at other timepoints (0-24h, 24-48h).
• Cumulative outpatient opioid demand and refills did not significantly differ between groups, though late refills were more common with RA.

Conclusions:

• Regional anesthesia was not associated with decreased opioid consumption or demand in femoral shaft fracture surgery.
• Findings suggest exploring alternative analgesic modalities for effective pain management in this patient population.