The Effect of Standardized Perioperative Patient Education on Opioid Use After Minor Soft Tissue Procedures Distal to the Wrist

被引:8
作者
Zohar-Bondar, Aaron [1 ]
Stepan, Jeffrey G. [2 ]
Chapman, Talia [1 ]
Sacks, Haley [1 ]
Verrett, Isabelle [1 ]
Fufa, Duretti T. [1 ]
机构
[1] Hosp Special Surg, Dept Orthopaed Surg, 535 E 70th St, New York, NY 10021 USA
[2] Univ Chicago, Dept Orthopaed Surg & Rehabil Med, Chicago, IL 60637 USA
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2022年 / 47卷 / 06期
关键词
Education; hand; opioid; pain; surgery; PAIN MANAGEMENT; CONSUMPTION; GUIDELINES; SURGERY;
D O I
10.1016/j.jhsa.2021.06.009
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose Several studies have explored opioid consumption and opioid prescriber education for upper extremity procedures; however, less literature has focused on patient-centered interventions and their impact on opioid consumption after surgery. The purpose of this study was to create a standardized perioperative patient education program regarding postoperative pain management after hand surgery and to determine if it could reduce opioid use after hand surgery. Methods Patients scheduled to undergo elective outpatient hand surgery comprising minor soft tissue procedures at and distal to the wrist were randomized to receive painmanagement education or standard care. Before the surgery, all patients viewed a webinar with instructions for participation, whereas the education group received an additional 10 minutes of education on postoperative pain management and a pain management reference card for review after the surgery. All patients completed a postoperative daily log documenting the number of opioids consumed, other pain management modalities used, and pain scores. The primary outcome of the number of opioid pills consumed by the patients was compared between the groups. We constructed a linear regression model to determine the risk factors for postoperative opioid use after surgery. Results One hundred seventy-four patients completed the study (n = 90 education group; n = 84 standard care group). Patients in the education group took significantly fewer opioid pills (median = 0, range 0-13) than those in the standard care group (median = 0.5, range 0-40). A linear regression model showed that average week-1 pain (B = 0.93; 95% confidence interval, 0.56-1.3) and the number of pills prescribed (B = 0.12; 95% confidence interval, 0.017-0.22) were predictive of greater opioid use. Conclusions Perioperative patient education significantly reduced postoperative opioid use following a minor soft tissue hand surgery, with greater than 70% of the patients taking no opioids. (Copyright (C) 2022 by the American Society for Surgery of the Hand. All rights reserved.)
引用
收藏
页码:580.e1 / 580.e9
页数:9
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