Brigham and Women's Hospital, Boston, Massachusetts.
Harvard Combined Orthopedic Residency Program, Boston, Massachusetts.
Foot Ankle Spec. 2022 Dec;15(6):545-550. doi: 10.1177/1938640020980921. Epub 2020 Dec 27.
Previous research indicates low disposal rates of excess postoperative narcotics, leaving them available for diversion or abuse. This study examined the effect of introducing a portable disposal device on excess opiate opioid disposal rates after lower extremity orthopaedic surgery.
This was a single site randomized control trial within an outpatient orthopaedic clinic. All patients 18 years or older, undergoing outpatient foot and ankle surgery between December 1, 2017 and August 1, 2018 were eligible. Patients were prospectively enrolled and randomized to receive standard opioid disposal instructions or a drug deactivation device at 2-week postoperative appointments. Participants completed an anonymous survey at 6-week postoperative appointments.
Of the 75 patients surveyed, 68% (n = 26) of the experimental group and 56% (n = 21) of the control group had unused opioid medication. Of these, 84.6% of patients who were given Deterra Drug Deactivation System deactivation pouches safely disposed of excess medication, compared with 38% of controls ( = .003). When asked if they would use a disposal device for excess medication in the future, 97.4% (n = 37) of the experimental and 83.8% (n = 31) of the control group reported that they would.
Providing a portable disposal device with postoperative narcotic prescriptions may increase safe disposal rates of excess opioid medication following lower extremity orthopaedic surgery.
Level I.
先前的研究表明，多余的术后麻醉剂的处理率较低，这使得它们有可能被转移或滥用。本研究旨在探讨在下肢矫形手术后引入便携式处理装置对过量阿片类药物处理率的影响。
这是一项在门诊矫形诊所进行的单站点随机对照试验。所有 18 岁及以上、于 2017 年 12 月 1 日至 2018 年 8 月 1 日期间接受门诊足踝手术的患者均符合入选条件。患者前瞻性入组并在术后 2 周的预约中随机接受标准阿片类药物处理说明或药物失活装置。参与者在术后 6 周的预约中完成了匿名调查。
在接受调查的 75 名患者中，实验组有 68%（n=26）和对照组有 56%（n=21）的患者仍有未使用的阿片类药物。在这些患者中，使用 Deterra 药物失活系统失活袋的患者中有 84.6%（n=26）安全处理了多余的药物，而对照组只有 38%（n=21）（n=0.003）。当被问及将来是否会使用处理装置来处理多余的药物时，实验组有 97.4%（n=37）的患者和对照组有 83.8%（n=31）的患者表示会。
提供一种与术后麻醉处方一起使用的便携式处理装置可能会增加下肢矫形手术后过量阿片类药物的安全处理率。
I 级。
