LAS VEGAS — Preoperative counseling did not significantly decrease opioid consumption after outpatient hand surgery; however, patients who did receive counseling were more satisfied with their postoperative pain experience, according to research presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
“Overall, patient satisfaction with their pain experience was very high and overall opioid consumption was very low,” Talia Chapman, MD, said during her presentation. “Many more opioids were prescribed than needed.”
Chapman and colleagues performed a prospective randomized study of 134 patients who underwent outpatient hand surgery. There were 62 patients assigned to receive preoperative counseling and 72 patients did not receive counseling. Investigators collected data on patient demographics, procedure type, anesthesia type and the number of opioids consumed. On postoperative day 3 patients were administered an electronic survey to determine number of opioids consumed, daily VAS scores, adverse events and the patient’s attitude toward their pain experience. The t-tests and Fisher’s exact tests were used respectively to determine continuous and dichotomous variables.
Results showed each patient on average was prescribed 13 pills. Investigators noted patients who received counseling vs. those who did not were not significantly different with regard to the average number of pills consumed and VAS pain scores. Older patients had significantly lower VAS pain scores and took fewer pills. Patients who underwent bony procedures compared with those who underwent soft tissue procedures consumed more pills.
According to researchers, patients who did not receive counseling and chronic opioid users thought the number of pills they were prescribed was insufficient. – by Monica Jaramillo
Chapman T, et al. Paper 110. Presented at: the American Academy of Orthopaedic Surgeons Annual Meeting; March 12-16, 2019; Las Vegas.
Disclosure: Talia reports no relevant financial disclosures.