Andelman Steven M, Bu Daniel, Debellis Nicholas, Nwachukwu Chukwuma, Osman Nebiyu, Gladstone James N, Colvin Alexis C
Department of Orthopaedic Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, U.S.A.
Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, New York, U.S.A.
Arthrosc Sports Med Rehabil. 2019 Dec 20;2(1):e33-e38. doi: 10.1016/j.asmr.2019.10.006. eCollection 2020 Feb.
To identify the current opioid prescribing and use practices after arthroscopic meniscectomy and to evaluate the role of preoperative patient education in decreasing postoperative opioid consumption.
Patients undergoing arthroscopic meniscectomy were prospectively identified for inclusion. They were placed into 1 of 2 groups: Group 1 received no education regarding opioid use after surgery, whereas group 2 received a standardized overview on postoperative opioid use. Patients were assigned to the groups consecutively: Patients treated at the beginning of the study were assigned to group 1, and patients treated at the end of the study were assigned to group 2. Data from group 1 were used to identify "normal" opioid prescribing and use practices and to guide patients in group 2 regarding normal postoperative opioid use. Patients were surveyed weekly for 4 weeks after surgery to determine the number of opioids taken. Postoperative opioid consumption was analyzed and compared between the 2 groups.
A total of 62 patients completed the study (32 in group 1 and 30 in group 2). Patients in group 1 were prescribed an average of 42.0 opioid pills (95% confidence interval [CI], 34.0-51.0 pills) and used an average of 15.84 pills (95% CI, 9.26-22.4 pills) after surgery, whereas patients in group 2 used an average of 4.00 pills (95% CI, 2.12-5.88 pills) after surgery. Patients in group 2 used 11.84 fewer opioid pills ( = .001), a 296% decrease in postoperative opioid consumption. The number of patients who continued to take opioid pills 4 weeks after surgery was 7 patients (21.9%) in group 1 and 1 patient (3.3%) in group 2.
Preoperative patient education regarding opioids may decrease postoperative opioid consumption and the duration for which patients take opioid pills after arthroscopic meniscectomy.
Level II, prospective comparative study.
确定关节镜下半月板切除术后当前的阿片类药物处方及使用情况，并评估术前患者教育在减少术后阿片类药物消耗方面的作用。
前瞻性纳入接受关节镜下半月板切除术的患者。他们被分为两组中的一组：第1组术后未接受关于阿片类药物使用的教育，而第2组接受了关于术后阿片类药物使用的标准化概述。患者连续分组：研究开始时治疗的患者被分配到第1组，研究结束时治疗的患者被分配到第2组。第1组的数据用于确定“正常”的阿片类药物处方及使用情况，并指导第2组患者关于正常的术后阿片类药物使用。术后每周对患者进行4周的调查，以确定服用的阿片类药物数量。分析并比较两组之间的术后阿片类药物消耗量。
共有62例患者完成了研究（第1组32例，第2组30例）。第1组患者术后平均被处方42.0片阿片类药物（95%置信区间[CI]，34.0 - 51.0片），平均使用15.84片（95%CI，9.26 - 22.4片），而第2组患者术后平均使用4.00片（95%CI，2.12 - 5.88片）。第2组患者少用11.84片阿片类药物（P = .001），术后阿片类药物消耗量减少296%。术后4周仍继续服用阿片类药物的患者数量在第1组为7例（21.9%），在第2组为1例（3.3%）。
术前对患者进行关于阿片类药物的教育可能会减少关节镜下半月板切除术后患者的阿片类药物消耗量以及服用阿片类药物的持续时间。
二级，前瞻性比较研究。
