دورية أكاديمية
Perioperative Opioid Counseling Reduces Opioid Use Following Primary Total Joint Arthroplasty.
| العنوان: | Perioperative Opioid Counseling Reduces Opioid Use Following Primary Total Joint Arthroplasty. |
|---|---|
| المؤلفون: | Carender CN; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA., Anthony CA; Penn Orthopaedics, Penn Medicine, Philadelphia, Pennsylvania, USA., Rojas EO; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA., Noiseux NO; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA., Bedard NA; Department of Orthopedics and Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA., Brown TS; Orthopedics & Sports Medicine in Texas Medical Center, Houston, Texas, USA. |
| المصدر: | The Iowa orthopaedic journal [Iowa Orthop J] 2022 Jun; Vol. 42 (1), pp. 169-177. |
| نوع المنشور: | Journal Article; Randomized Controlled Trial |
| اللغة: | English |
| بيانات الدورية: | Publisher: Residents and Faculty of the Dept. of Orthopaedics, University of Iowa Country of Publication: United States NLM ID: 8908272 Publication Model: Print Cited Medium: Internet ISSN: 1555-1377 (Electronic) Linking ISSN: 15415457 NLM ISO Abbreviation: Iowa Orthop J Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [Iowa City, IA] : Residents and Faculty of the Dept. of Orthopaedics, University of Iowa, |
| مواضيع طبية MeSH: | Arthroplasty, Replacement, Knee* , Opioid-Related Disorders*/drug therapy , Opioid-Related Disorders*/prevention & control, Analgesics, Opioid/therapeutic use ; Counseling ; Humans ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control |
| مستخلص: | Background: Preoperative counseling may reduce postoperative opioid requirements; however, there is a paucity of randomized controlled trials (RCTs) demonstrating efficacy. The purpose of this study was to perform an interventional, telehealth-based RCT evaluating the effect of peri-operative counseling on quantity and duration of opioid consumption following primary total joint arthroplasty (TJA). Methods: Participants were randomized into three groups: 1. Control group, no perioperative counseling; 2. Intervention group, preoperative educational video; 3. Intervention group, preoperative educational video and postoperative acceptance and commitment therapy (ACT). Opioid consumption was evaluated daily for 14 days and at 6 weeks postoperatively. Best-case and worse-case intention to treat analyses were performed to account for non-responses. Bonferroni corrections were applied. Results: 183 participants were analyzed (63 in Group 1, 55 in Group 2, and 65 in Group 3). At 2 weeks postoperatively, there was no difference in opioid consumption between Groups 1, 2, and 3 (p>0.05 for all). At 6 weeks postoperatively, Groups 2 and 3 had consumed significantly less opioids than Group 1 (p=0.04, p<0.001) (Table 1). Group 3 participants were less likely to obtain an opioid refill relative to Group 1 participants (p=0.04). Participants in groups 2 and 3 ceased opioid consumption a median of 6 days and 2 days sooner than Group 1, respectively (p<0.001, p=0.03) (Table 2). Conclusion: Perioperative opioid counseling significantly decreases the quantity and duration of opioid consumption at 6 weeks following primary TJA. Level of Evidence: I . (Copyright © The Iowa Orthopaedic Journal 2022.) |
| References: | J Hand Surg Am. 2017 Oct;42(10):810-815. (PMID: 28890331) J Rheumatol. 2019 Sep;46(9):1134-1140. (PMID: 30988126) J Bone Joint Surg Am. 2018 Feb 7;100(3):180-188. (PMID: 29406338) MMWR Morb Mortal Wkly Rep. 2017 Mar 17;66(10):265-269. (PMID: 28301454) Clin Orthop Relat Res. 2019 Jan;477(1):104-113. (PMID: 30794233) J Shoulder Elbow Surg. 2018 Jun;27(6):962-967. (PMID: 29599038) J Arthroplasty. 2018 Jan;33(1):19-24. (PMID: 29017803) J Bone Joint Surg Am. 2020 Jun 3;102(11):953-960. (PMID: 32251139) J Pain. 2018 Oct;19(10):1211-1221. (PMID: 29777950) J Arthroplasty. 2019 Jul;34(7S):S135-S139. (PMID: 30890390) J Med Internet Res. 2020 Jul 29;22(7):e17750. (PMID: 32723723) J Am Acad Orthop Surg. 2015 May;23(5):267-71. (PMID: 25911660) |
| فهرسة مساهمة: | Keywords: counseling; opioid; total hip arthroplasty; total knee arthroplasty |
| المشرفين على المادة: | 0 (Analgesics, Opioid) |
| تواريخ الأحداث: | Date Created: 20220713 Date Completed: 20220714 Latest Revision: 20220719 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9210409 |
| PMID: | 35821950 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1555-1377 |
|---|