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Risk Factors for Rescue Opioid Prescription After Cubital Tunnel Surgery.

Carew Giberson-Chen1, Christina Liu1, Phillip Grisdela1

  • 1Harvard Combined Orthopaedic Residency Program, Harvard Affiliated Hospitals, Boston, MA, USA.

Hand (New York, N.Y.)
|February 15, 2024
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Summary

Most patients do not need extra opioid prescriptions after cubital tunnel surgery. However, those with chronic pain or pain sensitivity syndromes may require additional pain management strategies.

Keywords:
chronic paincubital tunnel syndromediagnosisnerveopioidsprescriptionsrefills

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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Public Health

Background:

  • The opioid epidemic necessitates careful review of postoperative opioid prescribing.
  • Cubital tunnel surgery is a common orthopedic procedure.
  • Understanding risk factors for additional opioid prescriptions is crucial.

Purpose of the Study:

  • To identify patient- and procedure-specific risk factors for additional opioid rescue prescriptions after cubital tunnel surgery.

Main Methods:

  • Retrospective review of 274 patients undergoing cubital tunnel surgery at two academic medical centers.
  • Data collected included demographics, comorbidities, prior opioid history, and surgical variables.
  • Statistical analyses (univariate and bivariate) were used to determine risk factors.

Main Results:

  • 8% of patients required additional postoperative opioid rescue prescriptions.
  • Factors associated with increased need for rescue opioids included female sex, fibromyalgia, chronic opioid use, chronic pain diagnosis, and recent opioid use.
  • Median opioid prescription amounts varied by surgical technique (in situ vs. anterior transposition).

Conclusions:

  • Patients with chronic pain or pain sensitivity syndromes are at higher risk for needing additional opioids post-cubital tunnel surgery.
  • Multidisciplinary team collaboration for perioperative pain management is recommended for high-risk patients.