<< Back to the abstract archive
Optimization of Post-Operative Pain Control for Outpatient Hand Surgery: Soft Tissue, Bone, and Shoulder
Justine Kim, MD
Joseph Imbriglia, MD
University of Pittsburgh Medical Center
2021-01-26
Presenter: Justine Kim
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. 100% of the work is that of the resident.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
Purpose: After the opioid epidemic was deemed a public health emergency in 2017 by the U.S. Department of Health and Human Services, physicians in several specialties began making efforts to optimize acute post-operative pain while diminishing the use of opioids. This study aims to determine the number of narcotic pills used following hand and upper extremity procedures, define the expected duration of opioid usage post-operatively, and demonstrate the effects of opioid counseling on consumption and disposal.
Methods: From September 2019 to the present, all patients of a single hand surgeon at an outpatient surgery center reported duration of opioid use, number of pills remaining, use of adjunct non-narcotic medication, adverse effects, level of pain relief, receipt of pre-operative opioid counseling, and method of narcotic disposal.
Results / Anticipated Results: 111 patients completed the pain survey. 61 underwent soft tissue procedures; 37 bony; and 13 shoulder. Patients in the first group were prescribed 9 pills on average, though 52% did not take any narcotics. The second group was prescribed an average of 21 pills; 16% took zero narcotics. The third group was prescribed an average of 28 pills though patients only required an average of 14 pills. 73% received no pre-operative opioid counseling. 43% either kept excess medications for future personal use or gave them to family / friends.
Conclusion: Quality improvement interventions including opioid counseling and education on multimodal pain management can eliminate narcotic use in certain post-surgical patient populations, decrease the overall use of opioids, and enhance opioid stewardship.
