american journal of sports medicine
Can We Eliminate Opioid Medications for Postoperative Pain Control? A prospective, surgeon-blinded, randomized controlled trial in knee arthroscopic surgery.
Matthew Hartwell, et al. Am J Sports Med. 2020; 48(11): 2711-2717.
This study performed at the Feinberg School of Medicine at Northwestern University in Chicago examines the amount of opioid tablets utilized by patients undergoing partial meniscectomy. 115 patients were randomized into two groups. All patients were instructed on multimodal pain management using aspirin, acetaminophen, and naproxen. Group 1 was electronically prescribed oxycodone. Group 2 was given a physical prescription for oxycodone which was optional to fill.
RESULTS: There was no significant difference in the number of opioid tablets utilized by the different groups. The majority (89%) of patients provided with the option of filling a prescription for opioid medications ended up filling the prescription. Of the 1,820 tablets prescribed, only 380 (21%) were utilized. 35 patients (37%) did not take any opioid tablets after surgery.
My Big Takeaway: Yes, we can eliminate opioid pain medications following arthroscopic partial meniscectomy. Pain can be adequately controlled with a multimodal pain management strategy (aspirin, acetaminophen, naproxen). 79% of opioid tablets prescribed for pain control following arthroscopic partial meniscectomy are unused.
My Other Takeaway: When given a prescription by a physician, most patients will fill the prescription whether or not the medication is needed. One method to minimize use of opioid medications after surgery is for surgeons to discuss a multimodal pain management strategy with patients prior to surgery and not prescribe opioids.