Opioid Consumption After Knee Arthroscopy

Kamdar, Parth; Liddy, Nicole; Antonacci, Christopher L.; Mandava, Nikhil K.; Delos, Demetris; Vadasdi, Katherine B.; Cunningham, James G.; Kowalsky, Marc S.; Greene, R. Timothy; Alberta, Frank G.

doi:10.1016/j.arthro.2020.10.019

Cited by 9 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They found that the median number of 5-mg hydrocodone equivalent pills taken was 7 pills and that, The Orthopaedic Journal of Sports Medicine similar to our findings, the vast majority of patients had stopped taking pills by postoperative days 5 to 7. Similar to our findings in adolescents, in their study of adult patients undergoing knee arthroscopy, Kamdar et al 9 showed that no patients required more than five 5-mg oxycodone equivalent pills and 92% of patients required no pills after postoperative day 2. Our study differs from the mentioned studies in that our study specifically looks at the adolescent population, whereas other studies included adult patients who did not undergo ligamentous reconstruction or osteotomy type procedures.…”

Section: Discussionsupporting

confidence: 91%

Opioid Use After Knee Arthroscopy in Adolescent Patients: A Prospective Evaluation

Steinmetz¹,

Hamilton

Moritz

et al. 2023

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: There is a relative paucity of literature on how to best treat postoperative pain after knee arthroscopy in the adolescent population. Purpose: To evaluate the use of opioid medication after knee arthroscopy in adolescent patients. Study Design: Case series; Level of evidence, 4. Methods: We prospectively enrolled 50 patients aged 10 to 18 years who underwent 1 of the following procedures: diagnostic arthroscopy; plica excision; loose body removal; debridement; chondroplasty; meniscal repair; and/or partial meniscectomy. Patients already taking chronic pain medication and those undergoing revision knee arthroscopy, ligamentous reconstruction, or bony osteotomy procedures were excluded. Postoperatively, the patients were prescribed 15 tablets of hydrocodone/acetaminophen (5 mg/325 mg) every 6 hours as needed for pain. The patients were given a diary to record the number of postoperative opioid pills taken, days the pills were taken, pain level, and nonopioid pills taken. The data were collected and used to identify the mean number of opioid pills needed as well as the number of days opioid medication was needed postoperatively. Results: Of the 50 enrolled patients, 35 patients adequately completed the diary and were included in the study. The mean age in this cohort was 14.2 years. The total number of pills taken ranged from 0 to 14, with an overall mean of 5.41. Therefore, on average, patients utilized 36% of their postoperative prescriptions. In our cohort, 74.3% of patients had stopped taking opioids by postoperative day 3, with a mean of 3.8 pills, and 97.1% of patients had stopped taking opioids by postoperative day, 5 with a mean of 5.3 pills. No postoperative refills of opioid medication were necessary. Conclusion: After knee arthroscopy, the adolescents in our study consumed a mean of 5.41 opioid pills postoperatively, and over 97% of patients stopped opioid use by postoperative day 5. The results of this study should help in guiding physicians to avoid overprescribing opioid medication while treating postoperative pain after knee arthroscopy in this vulnerable patient population.

show abstract

Section: Discussionsupporting

confidence: 91%

Opioid Use After Knee Arthroscopy in Adolescent Patients: A Prospective Evaluation

Steinmetz¹,

Hamilton

Moritz

et al. 2023

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…Arthroscopic surgery is undoubtedly the mainstay of treatment for meniscal, ligament and cartilage injuries in sports medicine [2] . For pain control is an important part of knee arthroscopy [3] . As one of the most common anesthetic techniques, subarachnoid block can be used as the anesthetic of choice for lower extremity surgery such as knee arthroscopy, both for surgical needs and patient comfort.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures

Liu,

Sun,

Wang

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: Comparison of whether intrathecal dexmedetomidine prolongs spinal anesthesia-associated sensorimotor blockade more than intravenous infusion during knee arthroscopy procedures performed under subarachnoid block. Methods: Ninety patients aged 18-75 years, ASA class I-II, who underwent knee arthroscopy between October 2022 and April 2023 were randomized into intrathecal、intravenous and control groups.Subjects received three modes of administration: an intrathecal group (2ml of 1% ropivacaine + 5μg of dexmedetomidine，with saline pumped intravenously at a dose of 0.5μg/kg/h), an intravenous group (intrathecal 2ml of 1% ropivacaine +1ml of 0.9% saline, with dexmedetomidine pumped intravenously at a dose of 0.5μg/kg/h), and a control group (intrathecal 2ml of 1% ropivacaine + 1ml of 0.9% saline, with saline pumped intravenously at a dose of 0.5μg/kg/h). Total analgesic duration, duration of sensory and motor blockade, Ramsay sedation score, Visual Analogue Score (VAS) at different postoperative time points, and occurrence of adverse effects were recorded. Results：The total analgesia duration was significantly longer in the intrathecal group than in the intravenous and control groups (352.13±51.70min VS 273.47±62.57min VS 241.41±59.22min，P<0.001).The duration of sensory block was shorter in the intrathecal group than in the intravenous and control groups (4 [3-4]min VS 5 [4-5]min VS 5 [4-5]min；P<0.001);the duration of motor block was shorter in the intrathecal group than in the intravenous group and the control group (5 [4-5]min VS 5 [5-6]min VS 6[5.5-7]min；P<0.001).Sedation scores were higher in the intravenous group than in the intrathecal and control groups (P < 0.001). At 5 hours postoperatively, the VAS score in the intrathecal group was smaller than that in the intravenous and control groups (P<0.001). At 24 hours postoperatively, the VAS score in the intrathecal group was smaller than that in the control group (P < 0.001). In addition, the incidence of bradycardia was significantly higher in the intravenous group than in the intrathecal and control groups (30%, 6.5%, and 3.4%, respectively; P=0.018，P=0.007). Conclusions：Intrathecal administration of dexmedetomidine did prolong the total analgesia duration, as well as accelerate the onset of sensory-motor blockade compared with intravenous pumping, and did not result in any hemodynamic instability or other adverse events at the doses studied. Trial registration:This single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 26/09/2023 with the registration number ChiCTR2300076170.

show abstract

Editorial Commentary: Opioid Sparing Through Patient Education Programs Is the Future for Sports Medicine and Arthroscopic Surgery to Optimize Outcome

Rossi¹

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Opioid Consumption After Knee Arthroscopy

Cited by 9 publications

References 13 publications

Opioid Use After Knee Arthroscopy in Adolescent Patients: A Prospective Evaluation

Opioid Use After Knee Arthroscopy in Adolescent Patients: A Prospective Evaluation

Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures

Editorial Commentary: Opioid Sparing Through Patient Education Programs Is the Future for Sports Medicine and Arthroscopic Surgery to Optimize Outcome

Contact Info

Product

Resources

About