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Limiting Narcotic Utilization Following Ankle Fracture Surgery
Theresa Pak1, John Schlechter2
1Riverside University Health System, Riverside, California.
Journal of Surgical Orthopaedic Advances
|May 6, 2025
Summary
Multimodal pain management significantly reduced narcotic use after ankle fracture surgery. Patients required substantially fewer opioid tablets than typically prescribed, indicating potential for revised pain management guidelines.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Pharmacology
Background:
- Opioid utilization post-ankle fracture surgery is a significant concern.
- Traditional prescribing of opioid analgesics may exceed patient needs.
Purpose of the Study:
- To evaluate the effectiveness of multimodal pain modalities in reducing opioid consumption after ankle fracture surgery.
- To establish evidence-based prescribing guidelines for postoperative pain management.
Main Methods:
- Retrospective chart review of opioid-naive patients (18-65 years) undergoing ankle fracture surgery.
- Patients received a multimodal pain regimen including non-opioids and limited opioid prescriptions.
- Opioid utilization was tracked by analyzing filled prescriptions.
Main Results:
- 40% of patients did not fill any opioid tablets, while 40% filled 10 and 20% filled 20.
- No patients required more than 20 opioid tablets, a significant decrease from the previous institutional practice of 30-50 tablets.
- Favorable pain control was reported by most patients postoperatively.
Conclusions:
- Multimodal pain regimens effectively decrease narcotic utilization following ankle fracture surgery.
- Current opioid prescribing practices for ankle fractures may be excessive.
- This study supports the development of guidelines to reduce reliance on opioid analgesia.
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