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Regional anesthesia reduces inpatient and outpatient perioperative opioid demand in periarticular elbow surgery.

Publication ,  Journal Article
Cunningham, DJ; LaRose, MA; Zhang, GX; Au, S; MacAlpine, EM; Paniagua, AR; Klifto, CS; Gage, MJ
Published in: J Shoulder Elbow Surg
February 2022

HYPOTHESIS: Regional anesthesia (RA) can be used to manage perioperative pain in the treatment of periarticular elbow fracture fixation. However, the opioid-sparing benefit is not well-characterized. The hypothesis of this study was that RA had reduced inpatient opioid consumption and outpatient opioid demand in patients who had undergone periarticular elbow fracture surgery. METHODS: This study retrospectively reviews inpatient opioid consumption and outpatient opioid demand in all patients aged ≥18 years at a single Level I trauma center undergoing fixation of periarticular elbow (distal humerus and proximal forearm) fracture surgery (n=418 patients). In addition to RA vs. no RA, additional patient and operative characteristics were recorded. Unadjusted and adjusted models were constructed to evaluate the impact of RA and other factors on inpatient opioid consumption and outpatient opioid demand. RESULTS: Adjusted models demonstrated decreases in inpatient opioid consumption postoperation in patients with RA (13.7 estimated oxycodone 5-mg equivalents or OEs without RA vs. 10.4 OEs with RA from 0 to 24 hours postoperation, P = .003; 12.3 vs. 9.2 OEs from 24 to 48 hours postoperation, P = .045). Estimated cumulative outpatient opioid demand differed significantly in patients with RA (166.1 vs. 132.1 OEs to 6 weeks, P = .002; and 181 vs. 138.6 OEs to 90 days, P < .001). DISCUSSION: In proximal forearm and distal humerus fracture surgery, RA was associated with decreased inpatient and outpatient opioid demand after adjusting for baseline patient and treatment characteristics. These results encourage utilization of perioperative RA to reduce opioid use.

Duke Scholars

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

February 2022

Volume

31

Issue

2

Start / End Page

e48 / e57

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pain, Postoperative
  • Outpatients
  • Orthopedics
  • Inpatients
  • Humans
  • Elbow
  • Anesthesia, Conduction
  • Analgesics, Opioid
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Cunningham, D. J., LaRose, M. A., Zhang, G. X., Au, S., MacAlpine, E. M., Paniagua, A. R., … Gage, M. J. (2022). Regional anesthesia reduces inpatient and outpatient perioperative opioid demand in periarticular elbow surgery. J Shoulder Elbow Surg, 31(2), e48–e57. https://doi.org/10.1016/j.jse.2021.08.005
Cunningham, Daniel J., Micaela A. LaRose, Gloria X. Zhang, Sandra Au, Elle M. MacAlpine, Ariana R. Paniagua, Christopher S. Klifto, and Mark J. Gage. “Regional anesthesia reduces inpatient and outpatient perioperative opioid demand in periarticular elbow surgery.J Shoulder Elbow Surg 31, no. 2 (February 2022): e48–57. https://doi.org/10.1016/j.jse.2021.08.005.
Cunningham DJ, LaRose MA, Zhang GX, Au S, MacAlpine EM, Paniagua AR, et al. Regional anesthesia reduces inpatient and outpatient perioperative opioid demand in periarticular elbow surgery. J Shoulder Elbow Surg. 2022 Feb;31(2):e48–57.
Cunningham, Daniel J., et al. “Regional anesthesia reduces inpatient and outpatient perioperative opioid demand in periarticular elbow surgery.J Shoulder Elbow Surg, vol. 31, no. 2, Feb. 2022, pp. e48–57. Pubmed, doi:10.1016/j.jse.2021.08.005.
Cunningham DJ, LaRose MA, Zhang GX, Au S, MacAlpine EM, Paniagua AR, Klifto CS, Gage MJ. Regional anesthesia reduces inpatient and outpatient perioperative opioid demand in periarticular elbow surgery. J Shoulder Elbow Surg. 2022 Feb;31(2):e48–e57.
Journal cover image

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

February 2022

Volume

31

Issue

2

Start / End Page

e48 / e57

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pain, Postoperative
  • Outpatients
  • Orthopedics
  • Inpatients
  • Humans
  • Elbow
  • Anesthesia, Conduction
  • Analgesics, Opioid
  • Adult