Purpose
Several studies have explored opioid consumption and opioid prescriber education for
upper extremity procedures; however, less literature has focused on patient-centered
interventions and their impact on opioid consumption after surgery. The purpose of
this study was to create a standardized perioperative patient education program regarding
postoperative pain management after hand surgery and to determine if it could reduce
opioid use after hand surgery.
Methods
Patients scheduled to undergo elective outpatient hand surgery comprising minor soft
tissue procedures at and distal to the wrist were randomized to receive pain management
education or standard care. Before the surgery, all patients viewed a webinar with
instructions for participation, whereas the education group received an additional
10 minutes of education on postoperative pain management and a pain management reference
card for review after the surgery. All patients completed a postoperative daily log
documenting the number of opioids consumed, other pain management modalities used,
and pain scores. The primary outcome of the number of opioid pills consumed by the
patients was compared between the groups. We constructed a linear regression model
to determine the risk factors for postoperative opioid use after surgery.
Results
One hundred seventy-four patients completed the study (n = 90 education group; n =
84 standard care group). Patients in the education group took significantly fewer
opioid pills (median = 0, range 0–13) than those in the standard care group (median =
0.5, range 0–40). A linear regression model showed that average week-1 pain (B = 0.93;
95% confidence interval, 0.56–1.3) and the number of pills prescribed (B = 0.12; 95%
confidence interval, 0.017–0.22) were predictive of greater opioid use.
Conclusions
Perioperative patient education significantly reduced postoperative opioid use following
a minor soft tissue hand surgery, with greater than 70% of the patients taking no
opioids.
Type of study/level of evidence
Prognostic II.
Key words
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Article info
Publication history
Published online: July 28, 2021
Accepted:
June 14,
2021
Received:
March 10,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
