Opioid Use and Pain Decrease Between Days 3 and 7 After Quadriceps Tendon Anterior Cruciate Ligament Reconstruction...

Area of Science:

• Orthopedic Surgery
• Pain Management
• Adolescent Health

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure in adolescents.
• Quadriceps tendon (QT) autograft is a viable option for ACL reconstruction.
• Effective pain management is crucial for recovery and patient satisfaction following ACL reconstruction.

Purpose of the Study:

• To assess pain levels and opioid consumption in adolescents undergoing ACL reconstruction with QT autograft.
• To evaluate the impact of regional nerve blocks and indwelling catheters on pain and opioid use.
• To determine pain and opioid use patterns at various time points up to postoperative day 7.

Main Methods:

• A cohort of adolescents (<19 years) undergoing ACL reconstruction with QT all-inside technique was studied.
• All patients received general anesthesia with femoral and sciatic nerve blocks; some had an indwelling femoral nerve catheter.
• Pain levels (Numeric Rating Scale) and opioid use were recorded via surveys on specific postoperative days.

Main Results:

• Median opioid prescription was 15 tablets of 5 mg oxycodone.
• On postoperative day 3, 26.8% reported pain ≥5 and 26.8% reported opioid use.
• On postoperative day 7, only 5.5% reported pain ≥5 and 3.6% reported opioid use, with 35.2% never reporting opioid use.

Conclusions:

• Moderate pain can persist for 3 days after ACL reconstruction with QT in adolescents, even with regional blocks.
• Substantial pain and opioid consumption are uncommon by postoperative day 7.
• Indwelling femoral nerve catheters may reduce early postoperative opioid consumption without affecting pain scores.