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The impact of regional anesthesia on opioid demand in distal radius fracture surgery.

Publication ,  Journal Article
Cunningham, D; LaRose, M; Kinamon, T; MacAlpine, E; Au, S; Paniagua, A; Klifto, C; Gage, MJ
Published in: J Plast Surg Hand Surg
2023

PURPOSE: Regional anesthesia (RA) is commonly used in distal radius fracture surgery to reduce pain and opioid consumption. The purpose of this study was to evaluate the real-world impact of RA on inpatient and outpatient opioid consumption and demand in patients undergoing distal radius fracture surgery. METHODS: All patients ages 18 and older undergoing distal radius fracture surgery between 7/2013 and 7/2018 at a single institution (n = 969) were identified. Inpatient opioid consumption and outpatient opioid prescribing in oxycodone 5-mg equivalents (OE's) up to 90-d post-operative were recorded for patients with and without RA. Adjusted models were used to evaluate the impact of RA on opioid outcomes. RESULTS: Adjusted models demonstrated decreases in inpatient opioid consumption in patients with RA (10.7 estimated OE's without RA vs. 7.6 OE's with RA from 0 to 24 h post-op, 10.2 vs. 5.3 from 24 to 48 h post-op and 7.5 vs. 5.0 from 48 to 72 h post-op, p<.05). Estimated cumulative outpatient opioid demand was significantly higher in patients with RA (65.3 OE's without RA vs. 81.0 with RA from 1-month pre-op to 2-week post-discharge, 76.1 vs. 87.7 OE's to 6-weeks, and 80.8 vs. 93.5 OE's to 90-d, all p values for RA <.05) though rates of refill were significantly lower in patients with RA from 2-week to 6-week post-op compared to patients without RA. CONCLUSIONS: Patients undergoing RA in distal radius fracture surgery had decreased inpatient opioid consumption but increased outpatient demand after adjustment for patient and operative characteristics. LEVEL OF EVIDENCE: Level III, retrospective, therapeutic cohort study.

Duke Scholars

Published In

J Plast Surg Hand Surg

DOI

EISSN

2000-6764

Publication Date

2023

Volume

57

Issue

1-6

Start / End Page

299 / 307

Location

Sweden

Related Subject Headings

  • Wrist Fractures
  • Surgery
  • Retrospective Studies
  • Radius Fractures
  • Practice Patterns, Physicians'
  • Patient Discharge
  • Pain, Postoperative
  • Humans
  • Fracture Fixation, Internal
  • Cohort Studies
 

Citation

APA
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ICMJE
MLA
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Cunningham, D., LaRose, M., Kinamon, T., MacAlpine, E., Au, S., Paniagua, A., … Gage, M. J. (2023). The impact of regional anesthesia on opioid demand in distal radius fracture surgery. J Plast Surg Hand Surg, 57(1–6), 299–307. https://doi.org/10.1080/2000656X.2022.2070178
Cunningham, Daniel, Micaela LaRose, Tori Kinamon, Elle MacAlpine, Sandra Au, Ariana Paniagua, Christopher Klifto, and Mark J. Gage. “The impact of regional anesthesia on opioid demand in distal radius fracture surgery.J Plast Surg Hand Surg 57, no. 1–6 (2023): 299–307. https://doi.org/10.1080/2000656X.2022.2070178.
Cunningham D, LaRose M, Kinamon T, MacAlpine E, Au S, Paniagua A, et al. The impact of regional anesthesia on opioid demand in distal radius fracture surgery. J Plast Surg Hand Surg. 2023;57(1–6):299–307.
Cunningham, Daniel, et al. “The impact of regional anesthesia on opioid demand in distal radius fracture surgery.J Plast Surg Hand Surg, vol. 57, no. 1–6, 2023, pp. 299–307. Pubmed, doi:10.1080/2000656X.2022.2070178.
Cunningham D, LaRose M, Kinamon T, MacAlpine E, Au S, Paniagua A, Klifto C, Gage MJ. The impact of regional anesthesia on opioid demand in distal radius fracture surgery. J Plast Surg Hand Surg. 2023;57(1–6):299–307.

Published In

J Plast Surg Hand Surg

DOI

EISSN

2000-6764

Publication Date

2023

Volume

57

Issue

1-6

Start / End Page

299 / 307

Location

Sweden

Related Subject Headings

  • Wrist Fractures
  • Surgery
  • Retrospective Studies
  • Radius Fractures
  • Practice Patterns, Physicians'
  • Patient Discharge
  • Pain, Postoperative
  • Humans
  • Fracture Fixation, Internal
  • Cohort Studies