Reducing Opioid Use in Orthopaedic Surgery

The opioid crisis has been an issue in the United States since the mid-1990s, claiming numerous lives and presenting a significant challenge to health care clinicians. Various preoperative, intraoperative, and postoperative strategies aimed at reducing opioid consumption can be used by orthopaedic surgeons to help minimize this crisis. Preoperative screening tools can help identify patients at risk for prolonged opioid use, allowing for tailored interventions and counseling. Patient education initiatives, including multimedia presentations and handouts, have shown promising results in decreasing opioid consumption postoperatively. Intraoperatively, administering local and regional anesthesia in collaboration with anesthesia colleagues has proved effective for minimizing postoperative pain and opioid requirements. Postoperatively, alternative therapies such as acetaminophen, NSAIDs, and cryotherapy offer viable options for pain management while reducing reliance on opioids. In addition, the prudent prescribing of opioids, based on patient needs and expectations, coupled with refill options, helps minimize excess opioid supply and potential diversion. Orthopaedic surgeons are urged to embrace a multimodal approach to pain management and decrease opioids prescription while integrating these various strategies to optimize outcomes while mitigating the risks associated with opioid use.