Call Catherine M, Noyes Mary, Faour Kamli N W, Jeselskis Diane, Rana Adam J
Tufts University School of Medicine, Boston, MA, USA.
MMP Orthopedics & Sports Medicine, Maine Medical Center, Portland, ME, USA.
Arthroplast Today. 2025 Jul 10;34:101758. doi: 10.1016/j.artd.2025.101758. eCollection 2025 Aug.
Opioid overprescribing is a concern within the field of arthroplasty, and a growing body of evidence suggests surgeons can prescribe smaller quantities of opioids for orthopaedic postoperative pain management without compromising patient care. Current literature indicates prescribing trends in arthroplasty are shifting in response. Our institution has prioritized quality improvement projects focused on multimodal pain control for patients undergoing total joint arthroplasty procedures in an active attempt to reduce postoperative narcotic use. We highlight tips for instituting similar initiatives based on our institution's experience, including communication strategies, the importance of establishing the expectation for postoperative pain management by the orthopaedic surgery team, and the role for postoperative pill counts. Future initiatives aimed to facilitate these changes, including the upcoming legislation the Nonopioids Prevent Addiction in the Nation Act, are discussed.
阿片类药物过度处方是关节置换领域的一个问题，越来越多的证据表明，外科医生可以开具较少量的阿片类药物用于骨科术后疼痛管理，而不影响患者护理。当前文献表明，关节置换领域的处方趋势正在相应转变。我们机构已将质量改进项目作为优先事项，重点关注接受全关节置换手术患者的多模式疼痛控制，积极尝试减少术后麻醉药物的使用。我们根据本机构的经验，重点介绍了开展类似举措的小贴士，包括沟通策略、骨科手术团队确立术后疼痛管理预期的重要性以及术后药片计数的作用。还讨论了旨在促进这些变化的未来举措，包括即将出台的《全国非阿片类药物预防成瘾法案》。
