Evidenced-Based Opioid Prescribing Recommendations Following Hand and Upper-Extremity Surgery

Area of Science:

• Public Health
• Pain Management
• Surgical Outcomes

Background:

• The United States faces a severe opioid epidemic, with significant morbidity, mortality, and economic impact over two decades.
• Prescription opioids are a major driver of this public health crisis, necessitating improved analgesic stewardship among healthcare providers.
• While interventions like monitoring programs and multimodal strategies exist, specific guidelines for opioid use in hand and upper-extremity surgery are lacking.

Purpose of the Study:

• To develop comprehensive, evidence-based recommendations for postoperative analgesia.
• To address the scarcity of guidelines for managing pain after common hand and upper-extremity procedures.
• To support surgeons, particularly hand surgeons, in practicing responsible opioid prescribing.

Main Methods:

• Systematic review of existing literature on postoperative pain management.
• Analysis of current opioid prescribing patterns in hand and upper-extremity surgery.
• Development of evidence-based recommendations for analgesic regimens.

Main Results:

• Identification of key factors influencing postoperative pain in hand and upper-extremity surgery.
• Evaluation of the efficacy and safety of various analgesic modalities.
• Formulation of specific dosing and management strategies for common procedures.

Conclusions:

• Evidence-based guidelines are crucial for optimizing postoperative pain management and reducing opioid reliance.
• Implementing these recommendations can enhance analgesic stewardship among surgeons.
• This initiative aims to mitigate the impact of the opioid epidemic in the context of orthopedic and hand surgery.