Resident Physician, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC.
Attending Physician, Department of Orthopaedic Surgery, Wake Forest Baptist Medical Center, Winston-Salem, NC.
J Foot Ankle Surg. 2022 Sep-Oct;61(5):1071-1075. doi: 10.1053/j.jfas.2022.01.022. Epub 2022 Jan 23.
The United States is currently in an opioid crisis. In order improve the amount of misuse and overdoses from opioids, some institutions have begun to create protocols based off of state and federal opioid prescription regulations. Our purpose is to analyze the current opioid prescribing patterns in foot and ankle surgery and create an institutional protocol. A survey on current opioid prescribing patterns based on the podiatric surgery was sent out from November 20, 2020 to January 11, 2021 to all members of the North Carolina Foot and Ankle Society. One-hundred surgeons participated in the survey. The most commonly prescribed postoperative pain medication was Hydrocodone/acetaminophen 5 mg/325 mg and the most common quantity was between 21 and 30 tablets. The most common medication for local blocks reported was bupivacaine and lidocaine mixed performed as a block closest to the surgical site. We recommend creating an institutional based opioid protocol for foot and ankle surgeries based off of the procedure performed by the surgeon. We recommend limiting prescriptions to under 30 tablets and utilizing a local or regional pain block for podiatric surgeries.
美国目前正处于阿片类药物危机之中。为了减少阿片类药物的滥用和过量使用，一些机构已经开始根据州和联邦阿片类药物处方规定制定方案。我们的目的是分析足部和踝关节手术中目前的阿片类药物处方模式，并制定机构方案。从 2020 年 11 月 20 日至 2021 年 1 月 11 日，我们向北卡罗来纳足部和踝关节协会的所有成员发送了一份基于足踝外科的阿片类药物处方模式的调查。有 100 名外科医生参与了这项调查。最常开的术后止痛药是氢可酮/对乙酰氨基酚 5 毫克/325 毫克，最常见的剂量是 21 到 30 片。最常报告的局部阻滞药物是布比卡因和利多卡因混合，在靠近手术部位的地方进行阻滞。我们建议根据外科医生的手术情况，为足部和踝关节手术制定基于机构的阿片类药物方案。我们建议将处方限制在 30 片以下，并为足科手术使用局部或区域止痛阻滞。
