Evidence map›Paper›PMID 36991313›Full record

Observational studyBMC anesthesiology2023

A multi-disciplinary program for opioid sparse arthroplasty results in reduced long-term opioid consumption: a four year prospective study.

D-Yin Lin, Anthony J Samson, Freeda D'Mello, Brigid Brown, Matthew G Cehic, Christopher Wilson, Hidde M Kroon, Ruurd L Jaarsma

Open access · goldFull text readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC anesthesiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.4field-weighted citation impact, top 19% of its field
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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Review
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

8 authors at 3 institutions in 1 country.

D-Yin LinDepartment of Anaesthesia, Flinders Medical Centre, Flinders Drive Bedford Park, Adelaide, SA, 5042, Australia. d-yin.lin@sa.gov.au.
Anthony J SamsonDepartment of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Freeda D'MelloDepartment of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Brigid BrownDepartment of Anaesthesia, Flinders Medical Centre, Flinders Drive Bedford Park, Adelaide, SA, 5042, Australia.
Matthew G CehicDepartment of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Christopher WilsonDepartment of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Hidde M KroonDepartment of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Ruurd L JaarsmaDiscipline of Perioperative Medicine, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Flinders Medical Centre · AUFlinders University · AUUniversity of Adelaide · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe current opioid epidemic poses patient safety and economic burdens to healthcare systems worldwide. Postoperative prescriptions of opioids contribute, with reported opioid prescription rates following arthroplasty as high as 89%. In this multi-centre prospective study, an opioid sparing protocol was implemented for patients undergoing knee or hip arthroplasty. The primary outcome is to report our patient outcomes in the context of this protocol, and to examine the rate of opioid prescription on discharge from our hospitals following joint arthroplasty surgery. This is possibly associated with the efficacy of the newly implemented Arthroplasty Patient Care Protocol.

methodsOver three years, patients underwent perioperative education with the expectation to be opioid-free after surgery. Intraoperative regional analgesia, early postoperative mobilisation and multimodal analgesia were mandatory. Long-term opioid medication use was monitored and PROMs (Oxford Knee/Hip Score (OKS/OHS), EQ-5D-5 L) were evaluated pre-operatively, and at 6 weeks, 6 months and 1 year postoperatively. Primary and secondary outcomes were opiate use and PROMs at different time points.

resultsA total of 1,444 patients participated. Two (0.2%) knee patients used opioids to one year. Zero hip patients used opioids postoperatively at any time point after six weeks (p < 0.0001). The OKS and EQ-5D-5 L both improved for knee patients from 16 (12-22) pre-operatively to 35 (27-43) at 1 year postoperatively, and 70 (60-80) preoperatively to 80 (70-90) at 1 year postoperatively (p < 0.0001). The OHS and EQ-5D-5 L both improved for hip patients from 12 (8-19) preoperatively to 44 (36-47) at 1 year postoperatively, and 65 (50-75) preoperatively to 85 (75-90) at 1 year postoperatively (p < 0.0001). Satisfaction improved between all pre- and postoperative time points for both knee and hip patients (p < 0.0001).

conclusionsKnee and hip arthroplasty patients receiving a peri-operative education program can effectively and satisfactorily be managed without long-term opioids when coupled with multimodal perioperative management, making this a valuable approach to reduce chronic opioid use.

Indexed as

Arthroplasty, Replacement, HipArthroplasty, Replacement, KneePostoperative PainAnalgesics, OpioidDrug PrescriptionsHumansProspective StudiesAnalgesics, Opioid

Identifiers

PMID36991313
PMCPMC10050824
OpenAlexW4361291756

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read68
Read underepoch 390

Registered trials

None linked

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.