Abstract | INTRODUCTION: METHODS: This study evaluated inpatient post-operative opioid consumption (0-24 h, 24-48 h, 48-72 h) and outpatient opioid demand (discharge to 2 weeks, 6 weeks, and 90 days) in all patients ages 18 and older undergoing operative treatment of distal femur fractures at a single institution from 7/2013 to 7/2018 (n = 230). Unadjusted and adjusted multivariable models were used to evaluate the impact of RA and other baseline patient and operative characteristics on inpatient opioid consumption and outpatient opioid demand. RESULTS: Adjusted models demonstrated a small, significant increase in inpatient opioid consumption in patients with RA compared to no RA (4.7 estimated OE's without RA vs 6.2 OE's with RA from 24- to 48-h post-op, p < 0.05) but otherwise no significant differences at other timepoints (6.7 estimated OE's without RA vs 6.9 OE's with RA from 0- to 24-h post-op and 4.5 vs 4.4 from 48- to 72-h post-op, p > 0.05). Estimated cumulative outpatient opioid demand was significantly higher in patients with RA from discharge to 6 weeks and to 90 days (55.8 OE's without RA vs 63.9 with RA from discharge to 2 weeks, p > 0.05; 74.9 vs 95.1 OE's to 6 weeks, and 85 vs 113.1 OE's to 90 days, p < 0.05). DISCUSSION: In distal femur fracture surgery, RA was associated with increased inpatient and outpatient opioid demand after adjusting for baseline patient and treatment characteristics. These results call into question the routine use of RA in distal femur fractures. LEVEL OF EVIDENCE: Level III, retrospective, therapeutic cohort study.
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Authors | Daniel J Cunningham, Ariana R Paniaugua, Micaela A LaRose, Isabel F DeLaura, Michael K Blatter, Mark J Gage |
Journal | Archives of orthopaedic and trauma surgery
(Arch Orthop Trauma Surg)
Vol. 142
Issue 8
Pg. 1873-1883
(Aug 2022)
ISSN: 1434-3916 [Electronic] Germany |
PMID | 33938985
(Publication Type: Journal Article)
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Copyright | © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. |
Chemical References |
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Topics |
- Adolescent
- Analgesics, Opioid
(therapeutic use)
- Anesthesia, Conduction
- Cohort Studies
- Femur
- Humans
- Inpatients
- Outpatients
- Pain, Postoperative
(drug therapy)
- Retrospective Studies
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