Decreasing Postoperative Opioid Prescriptions After Orthopedic Trauma Surgery: The "Lopioid" Protocol.
Pain Med
; 23(10): 1639-1643, 2022 09 30.
Article
in En
| MEDLINE
| ID: mdl-34999901
ABSTRACT
OBJECTIVE:
To assess the effectiveness of a multimodal analgesic regimen containing "safer" opioid and non-narcotic pain medications in decreasing opioid prescriptions after surgical fixation in orthopedic trauma.DESIGN:
Retrospective cohort study.SETTING:
One urban, academic medical center.SUBJECTS:
Patients with traumatic fracture from 2018 (n=848) and 2019 (n=931).METHODS:
In 2019, our orthopedic trauma division began a standardized protocol of postoperative pain medications that included 50 mg of tramadol four times daily, 15 mg of meloxicam once daily, 200 mg gabapentin twice daily, and 1 g of acetaminophen every 6 hours as needed. This multimodal regimen was dubbed the "Lopioid" protocol. We compared patients who received this protocol with all patients from the prior year who had followed a standard protocol that included Schedule II narcotics.RESULTS:
Greater mean morphine milligram equivalents were prescribed at discharge from fracture surgery under the standard protocol than under the Lopioid protocol (252.3 vs 150.0; P < 0.001), and there was a difference in the type of opioid medication prescribed (P < 0.001). There was a difference in the number of refills filled for patients discharged with opioids after surgical treatment between the standard and Lopioid cohorts (0.31 vs 0.21; P = 0.002). There were no differences in the types of medication-related complications (P = 0.710) or the need for formal pain management consults (P = 0.199), but patients in the Lopioid cohort had lower pain scores at discharge (2.2 vs 2.7; P = 0.001).CONCLUSIONS:
The Lopioid protocol was effective in decreasing the amount of Schedule II narcotics prescribed at discharge and the number of opioid refills after orthopedic surgery for fractures.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tramadol
/
Orthopedic Procedures
Type of study:
Etiology_studies
/
Guideline
/
Observational_studies
Limits:
Humans
Language:
En
Journal:
Pain Med
Journal subject:
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2022
Document type:
Article