Lubitz Marc G, Latario Luke, Ogbeide-Latario Oghomwen, Hughes Kevin, Clegg Stephanie, Molla Vadim, Brown Michael, Busconi Brian, DeAngelis Nicola
Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Chan, School of Medicine, Worcester, Massachusetts, U.S.A.
University of Massachusetts Chan Medical Science Training Program, Worcester, Massachusetts, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Feb 27;6(2):100885. doi: 10.1016/j.asmr.2024.100885. eCollection 2024 Apr.
To determine whether access to a website with an educational video would decrease postoperative opioid use in patients undergoing arthroscopic partial meniscectomy.
Enrolled patients who underwent arthroscopic partial meniscectomy at a single center were randomized to either the intervention or control group prior to surgery. The intervention group received a card with access to an online educational video regarding opioids with their postoperative instructions; the control group did not. The online video was just over 5 minutes long and contained general information about the dangers of opioid use, how to safely dispose of unused opioids, and local support contact information. Data were collected by telephone 10 to 14 days postoperatively and analyzed with GraphPad Prism version 9.5.0. Patient characteristics including age, sex, body mass index, allergies, smoking, depression, alcohol abuse, American Society of Anesthesiologists level, diagnosis of chronic obstructive pulmonary disease, hypertension, diabetes, substance abuse, employment status, workers' compensation, and sports participation were analyzed and correlated with postoperative opioid use.
A total of 166 patients were included in this study, with 78 in the control group and 88 in the intervention group. Mean number of pills consumed was 3 in the control group and 2.2 in the intervention group. This difference did not reach statistical significance. Patients who were obese, smokers, or diagnosed with depression both consumed more opioids and were less likely to take no narcotics postoperatively. Patients who participated in sports consumed fewer total opioids on average than those who did not. Subgroup analysis of patients with higher risk factors did not show a difference between the control and intervention groups in the average amount of opioid used or the likelihood of using no narcotics. Among all patients, 82 (49%) used no narcotics postoperatively and 90% used 8 or fewer tablets.
Directing patients to an educational website and video is not an effective tool in decreasing opioid consumption. Patients undergoing arthroscopic meniscectomy who are obese, active smokers, and clinically depressed or do not participate in sports are likely to use more postoperative narcotics. Regardless of access to the online educational video, half of patients used no narcotics.
Level II, prospective cohort.
确定访问一个带有教育视频的网站是否会减少接受关节镜下半月板部分切除术患者的术后阿片类药物使用量。
在单一中心接受关节镜下半月板部分切除术的入选患者在手术前被随机分为干预组或对照组。干预组在术后指导中收到一张可访问关于阿片类药物的在线教育视频的卡片；对照组则没有。在线视频时长刚超过5分钟，包含阿片类药物使用风险的一般信息、如何安全处理未使用的阿片类药物以及当地支持联系信息。术后10至14天通过电话收集数据，并使用GraphPad Prism 9.5.0版进行分析。分析患者特征，包括年龄、性别、体重指数、过敏史、吸烟情况、抑郁情况、酗酒情况、美国麻醉医师协会分级、慢性阻塞性肺疾病诊断、高血压、糖尿病、药物滥用情况、就业状况、工伤赔偿以及运动参与情况，并将其与术后阿片类药物使用情况进行关联分析。
本研究共纳入166例患者，其中对照组78例，干预组88例。对照组平均服用药片数为3片，干预组为2.2片。这种差异未达到统计学意义。肥胖、吸烟或被诊断为抑郁的患者服用的阿片类药物更多，且术后不服用麻醉药品的可能性更小。参与运动的患者平均服用的阿片类药物总量比未参与运动的患者少。对具有较高风险因素患者的亚组分析显示，对照组和干预组在阿片类药物平均使用量或不使用麻醉药品的可能性方面没有差异。在所有患者中，82例（49%）术后未使用麻醉药品，90%的患者使用了8片或更少的药片。
引导患者访问教育网站和视频并非减少阿片类药物使用量的有效工具。接受关节镜半月板切除术的肥胖、现吸烟者、临床抑郁或不参与运动的患者术后可能使用更多麻醉药品。无论是否访问在线教育视频，一半的患者未使用麻醉药品。
二级，前瞻性队列研究。
