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Nonopioid Pain Protocol Feasible After Sports Orthopedic Surgery

FRIDAY, Aug. 21, 2020 -- For patients undergoing common orthopedic sports procedures, a multimodal, nonopioid pain protocol featuring little or no use of opioids is feasible for managing postoperative pain, according to a study published in the August issue of Arthroscopy.

Vasilios Moutzouros, M.D., from the Henry Ford Hospital in Detroit, and colleagues conducted a prospective study to assess a custom multimodal nonopioid pain protocol in 141 patients undergoing common orthopedic sports procedures. Patient pain was reported immediately after surgery and at one week postoperatively, and rescue opioid use for breakthrough pain was recorded.

The researchers found that the mean visual analog scale for pain was 3.2 ± 2.3 one week following surgery, requiring an average of 2.6 ± 3.6 breakthrough oxycodone pills (8.6 ± 12.0 morphine equivalents). Overall, 45 percent of the patients reported satisfaction with pain management and did not require breakthrough prescription opioids. Compared with nonusers, patients who required opioids were more likely to have a history of anxiety/depression (44.2 versus 23.8 percent) and reported greater pain scores (3.94 ± 2.5 versus 2.41 ± 1.75). Feeling drowsy was the most common side effect of the pain protocol (23.5 percent). All patients were satisfied with their postoperative pain management.

"This type of research allows physicians to look at how we manage pain differently in the postsurgical environment," Moutzouros said in a statement. "It allows us to change our practices and become safer."

Several authors disclosed financial ties to the medical device industry.

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