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Opioid Consumption After Upper Extremity Surgery: A Systematic Review.

Minh N Q Huynh1, Morgan Yuan2, Lucas Gallo1

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This summary is machine-generated.

Opioid prescriptions after upper extremity surgery are frequently excessive, with patients consuming less than half of their prescribed medication. This systematic review highlights the need for better opioid prescribing practices and further research.

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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Pharmacology

Background:

  • Opioid overprescription is a significant concern, potentially leading to abuse and diversion.
  • Understanding post-operative opioid consumption is crucial for optimizing pain management strategies after upper extremity surgery.

Approach:

  • Systematic review adhering to PRISMA guidelines, registered on Open Science Framework (osf.io/6u5ny).
  • Searched MEDLINE, Embase, PubMed, and Cochrane Central Register of Controlled Trials (inception to October 17, 2021).
  • Included 21 studies (7 RCTs, 14 prospective cohort) involving 4195 patients undergoing upper extremity surgery; assessed risk of bias.

Key Points:

  • Patients consumed a median of 11% to 77% of prescribed opioids, indicating significant underutilization.
  • Most patients took less than half of the prescribed opioid dosage.
  • Included studies exhibited moderate to severe risk of bias.

Conclusions:

  • Routine overprescription of opioids occurs following upper extremity surgery.
  • Further high-quality randomized trials are needed to standardize opioid consumption reporting and evaluate patient-reported outcomes.