Research Day
THE EFFECT OF PRESCRIBING PATTERNS ON UTILIZATION OF OPIOID MEDICATION IN ACL RECONSTRUCTION: A RANDOMIZED, PROSPECTIVE TRIAL
Document Type
Abstract
Date
2021
Abstract
Introduction: The relationship between the opioid pill count prescribed after orthopaedic procedures and post-operative consumption has not been thoroughly investigated. This study sought to determine what relationship exists between the number of prescribed opioids and post-operative consumption for patients undergoing anterior cruciate ligament reconstruction (ACLR).
Methods: This is a prospective, randomized trial investigating the use of 3 different opioid prescription amounts following ACLR. Patients were randomized to one of 3 groups pre-operatively: 15, 25, and 35 oxycodone-5mg tablets. Adductor canal or femoral nerve blocks using bupivacaine/ropivacaine were utilized in all patients. Patients were asked to complete a pain and medication log for 14 days post-operatively, a pain management satisfaction survey, and IKDC questionnaires pre-operatively through 6 months post-operatively.
Results: 74 patients (24: 15-oxycodone, 18: 25-oxycodone, 21: 35-oxycodone) were enrolled. The difference between groups in the IKDC score did not differ pre-operatively (P=0.62) or at 6 months (P=0.56). Reported daily pain logs did not differ at any time point in regard to pain (P=0.16 to P=0.99) or satisfaction with pain management (P=0.20 to P=0.92) throughout the first 14 days. Mean consumption of opioids in MME (morphine milligram equivalents) in the first 14 post-operative days was 76.6mg ± 69.8 for all patients, and there was no difference in consumption between groups (P=0.578). There was no difference when asked about satisfaction with the initial prescription amount (P=0.415).
Conclusion: There is no difference in consumption of opioids or satisfaction with post-operative pain management based on initial prescription amount of oxycodone following ACLR.