Division of Spine, Department of Orthopedic Surgery, NYU Langone Health, New York, NY.
Clin Spine Surg. 2022 Jun 1;35(5):E478-E482. doi: 10.1097/BSD.0000000000001279. Epub 2021 Dec 15.
A single-center, retrospective review of prospectively collected data on patients who underwent single-level anterior cervical discectomy and fusions (ACDFs) between October 2014 and October 2019.
To investigate the effect of perioperative narcotic consumption and amount of narcotic prescribed at discharge on patient satisfaction with pain control after single-level ACDF.
Prior research has demonstrated that opioid prescription habits may be related to physician desire to produce superior patient satisfaction with pain control.
Patients with complete Press-Ganey Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey information were analyzed. Inpatient opioid prescriptions were recorded and converted to milligram morphine equivalents (MME) and tablets of 5 mg oxycodone. HCAHPS scores were converted to a Likert-type 5-point scale.
A total of 47 patients met inclusion criteria for this study. Average age was 48.1±10.9 y. Average inpatient opioids prescribed was 102±106 MME. Average opioids prescribed at discharge was 437±342 MME. No statistically significant correlation was found between satisfaction with pain control and opioid consumption while in the hospital [r=-0.106, P=0.483]. Similarly, there was no statistically significant correlation between satisfaction with pain control and opioids prescribed upon discharge [r=-0.185, P=0.219]. No statistically significant correlation was found between date of surgery and inpatient MME consumption [r=-0.113, P=0.450]. Interestingly, more opioids were prescribed at discharge the earlier the date of surgery [r=-0.426, P=0.003]. For every additional month further along in the study period, the odds of a patient reporting a top box score for satisfaction with pain control increased by 5.5% [P=0.025].
Our study found no correlation between patient satisfaction with pain control and inpatient opioid dosage or outpatient prescription dosage after single-level ACDF. Moreover, satisfaction with pain control increased over time despite a decrease in MME prescribed at discharge. This suggests that factors other than narcotic consumption play a more important role in patient satisfaction with pain control.
Level III.
回顾性分析 2014 年 10 月至 2019 年 10 月间接受单节段前路颈椎间盘切除融合术（ACDF）的患者前瞻性收集的数据的单中心研究。
探讨单节段 ACDF 术后患者围手术期阿片类药物消耗和出院时开具的阿片类药物数量对疼痛控制满意度的影响。
先前的研究表明，阿片类药物的处方习惯可能与医生对疼痛控制的满意度有关。
分析了具有完整的民意调查医院消费者评估医疗保健提供者和系统（HCAHPS）调查信息的患者。记录住院期间阿片类药物处方，并转换为吗啡毫克当量（MME）和 5mg 羟考酮片。HCAHPS 评分转换为 5 分制的李克特量表。
共有 47 例患者符合本研究的纳入标准。平均年龄为 48.1±10.9 岁。平均住院期间开具的阿片类药物为 102±106 MME。出院时开具的阿片类药物平均为 437±342 MME。患者对疼痛控制的满意度与住院期间的阿片类药物消耗之间无统计学显著相关性（r=-0.106，P=0.483）。同样，患者对疼痛控制的满意度与出院时开具的阿片类药物之间也无统计学显著相关性（r=-0.185，P=0.219）。手术日期与住院 MME 消耗之间无统计学显著相关性（r=-0.113，P=0.450）。有趣的是，手术日期越早，出院时开具的阿片类药物越多[r=-0.426，P=0.003]。在研究期间每增加一个月，患者对疼痛控制满意度的最高评分报告增加 5.5%[P=0.025]。
我们的研究发现，单节段 ACDF 后患者对疼痛控制的满意度与住院期间阿片类药物剂量或门诊处方剂量之间无相关性。此外，尽管出院时开具的 MME 减少，但疼痛控制的满意度随时间增加。这表明，除了阿片类药物的消耗外，其他因素在患者对疼痛控制的满意度中起着更重要的作用。
III 级。
