Evidence map›Paper›PMID 33124440›Full record

ArticleHand (New York, N.Y.)2022

Complete Abolition of Opioid Prescribing in an Upper Extremity Surgical Practice.

Mark Henry

Abstract read
In one paragraph

Article in Hand (New York, N.Y.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Larger Perioperative Opioid Prescriptions Lead to Prolonged Opioid Use After Hand and Upper Extremity Surgery: A Multicenter Analysis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Mark HenryHand & Wrist Center of Houston, TX, USA.ORCID 0000-0003-3973-1428

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrescription opioids threaten potential addiction, diversion, and death. Nonopioid regimens have demonstrated similar efficacy for select upper extremity postoperative patients.

methodsAfter adopting a practice policy completely abolishing opioid prescriptions, data were collected on all consecutive surgical cases for the next 6 months, without exclusion. There were 800 cases, 61% male and 39% female, with a mean age of 45. Seventy patients (9%) reported already using prescription medications employed in multimodality regimens; no instruction was given to alter consumption. Patients were divided into 5 groups based on the type of surgery: elective soft tissue (24%), trauma wound management (19%), soft tissue structural repairs (9%), hand fracture/bone procedures (34%), and wrist to elbow fracture/bone procedures (14%). Each group was compared directly to each other group with a 2-tailed

resultsPatients reported achieving pain control without the need for further medication assistance by a mean of postoperative day 2.7. Times to pain control by group were as follows: 1.5, 3.1, 2.7, 2.9, and 3.6 days respectively. Mean postoperative daily pain scores (using a 10-point visual analog scale) for days 1 to 5 were as follows: 2.8, 2.1, 1.5, 1.0, and 0.6, respectively, with a sum of 8.0. During the 6-month tracking period, the practice only received 4 calls from patients with questions about pain control (0.5% of cases).

conclusionsPatients achieved good immediate pain control without opioids and reported rapidly declining pain levels over the next several days to the point of no longer requiring medication. TYPE OF STUDY/LEVEL OF EVIDENCE: Prospective cohort case series, therapeutic; Level IV.

Indexed as

Analgesics, OpioidPractice Patterns, Physicians'FemaleHumansMaleMiddle AgedPostoperative PainProspective StudiesUpper ExtremityAnalgesics, Opioidaddictiondiagnosisopioidpainpostoperativesurgical

Identifiers

PMID33124440
PMCPMC9465782

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.