Multimodal pain management, limiting prescriptions can reduce opiate use after TKR
ORLANDO — Reducing opioid use is an ongoing concern despite that oral opiates remain an important component of pain management for some patients who undergo total knee replacement, a presenter said at the Current Concepts in Joint Replacement Winter Meeting.
The goal of reducing opioid use by half is realistic, Matthew J. Kraay, MD, said.
Orthopedic surgeons must be aware of and change situations in which overprescribing of opiates occurs, he said, because overprescribing can encourage overuse by patients, as well as diversion of opiates for non-medical use by patients and others.
“Avoid overprescribing,” Kraay said.
In his presentation, Kraay said it was not a good idea to put patients on opiates for pain management while they await surgery and “it should be avoided.”
In addition, “we try to limit prescriptions to a 1-week supply,” he said.
Kraay also recommended shortening postoperative prescribing of opioids to fewer than 6 weeks, an approach he said is reasonable.
“We, as surgeons, need to understand the risk of opiate use. We need to identify patients at risk for opiate abuse, addiction and overdose. We need to eliminate or reduce preoperative opiate use in our patients [and] minimize perioperative opioid use with multimodal pain management protocols,” Kraay said.
Kraay said he and his colleagues recently started looking into using cryotherapy as an adjunctive pain management method. – by Susan M. Rapp
Kraay MJ. Paper 82. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 11-14, 2019; Orlando.
Disclosure: Kraay reports no relevant financial disclosures.