The researchers aimed to judge the relationship between opioid prescriptions during the immediate, post-discharge period and patient-reported pain outcomes for a study. Patients who underwent one of 10 spinal procedures; patients with preoperative, postoperative day (POD 1, and POD 30 pain scores reported on the visual analog scale (VAS); patients discharged without a complicated perioperative course were taken under consideration. Smoking status and postoperative LOS were related to opioid prescription doses. Patients recommended opioids less than 40 MME/day, equal to 5 tablets of 5 mg oxycodone/day, showed no significant difference in POD 30 VAS score (β coefficient: 0.095, P=0.752) when compared to patients who received the highest-dose opioids (>80 MME/day—equivalent to 10 tablets of 5 mg oxycodone/day). Adjusted multivariable logistic regression analysis disclosed that postoperative opioid dosage/prescription was not a significant predictor of patients reporting at least 50% pain improvement, it suggested that 40 MME/day was sufficient to maintain patient satisfaction. Patients who received the lowest opioid prescriptions with sufficient non-opiate analgesics did not report worse pain relief at POD 30 than those receiving higher opioid prescriptions. In light of the opioid epidemic, outlines supported initial dosing prescriptions by the American Society for Addiction Medicine.

 

Link:journals.lww.com/spinejournal/Abstract/2021/11150/Tranexamic_Acid_in_Pediatric_Scoliosis_Surgery__A.4.aspx

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