Opioid Use for Postoperative Pain Control in Pediatric Supracondylar Humerus Fractures: A Pain-Diary Based Prospective Study
Journal Title: Journal of Orthopaedic Science and Research - Year 2021, Vol 2, Issue 2
Abstract
Introduction: There is limited research on postoperative pain control in pediatric populations following operative fixation of a Supracondylar Humerus (SCH) fractures. The purpose of the current study is to characterize the effectiveness of opioids vs non-opioid medication for postoperative pain control in pediatric patients following Closed Reduction Percutaneous Pinning (CRPP) of a SCH fracture. Methods: An IRB-approved prospective study was conducted from November 2019 to June 2020 and eight patients were enrolled in the study. They received CRPP for a SCH fracture at our institution. These patients were instructed to complete a postoperative pain diary recording their level of pain as well as medication usage. For pain control, the patients were counselled to alternate acetaminophen and ibuprofen and were also prescribed a short course of hydrocodone-acetaminophen for severe pain. T-tests were performed to compare pain ratings and medication usage between each group. Results: Of the eight patients in the study, three of the patients used opioid medication for pain control (in addition to acetaminophen and ibuprofen) and five patients used exclusively nonopioid medication for pain control (only acetaminophen and ibuprofen); from here-in these patients will be referred to as the “opioid group” and the “non-opioid” group, respectively. The opioid group and the non-opioid group did not differ significantly in age, weight, Gartland fracture type, or percent female (Table 1). The average total pain scores were 6.2 in the opioid group and 3.3 in the non-opioid group (p=0.03). For both groups, average pain scores were highest on the day of surgery and were lowest on postoperative day 4. The opioid group had higher pain scores on postoperative day 4 when compared with the non-opioid group and these results were statistically significant (p=0.04). The difference in acetaminophen and ibuprofen use between the two study groups was not statistically significant. Discussion: Our results demonstrate that 62% of our patient cohort managed their postoperative pain control with non-opioid pain medication. When compared with the opioid group, the non-opioid group had lower overall average pain scores. These results suggest that appropriate pain control can be achieved without opioids in the majority of patients.
Authors and Affiliations
Ryan J O’Leary, Leah Herzog, Sara Van Nortwick, Matthew A Dow, Robert F Murphy
Keywords
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- EP ID EP698817
- DOI http://dx.doi.org/10.46889/JOSR.2021.2202
- Views 64
- Downloads 0
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