Patient Satisfaction and Opioid Use With a Postoperative Opioid Protocol After Common Hand Procedures

Abstract

Purpose: Given the state of the opioid crisis and national pressure to minimize prescriptions, pain management after common hand procedures can pose a challenge for patients and providers. Despite the volume of recent literature on prescribing protocols and over-the-counter (OTC) medications, patient satisfaction has not been adequately assessed. The purposes of this study were (1) to investigate patient satisfaction with pain management using an opioid prescribing protocol after common hand procedures, and (2) to evaluate medication use in the postoperative period using this opioid prescribing protocol. Methods: A prospective survey was administered to 100 consecutive patients undergoing common soft tissue hand procedures at a Level I academic institution over a 5-month period. The medical record was reviewed for demographics and the number or dosage of opioid pills prescribed. The survey was conducted at 2 time points within 2 weeks after the procedure and assessed the number of opioid pills taken, use of OTC medications, visual analog scale (VAS) pain score, and satisfaction with pain management and surgery. Results: Mean number of opioid pills consumed at 2 weeks after the procedure was 1.5; 19 patients consumed all of their prescribed opioid pills. Acetaminophen was the most commonly used OTC medication and 84 patients reported using OTC medication in the postoperative period. The average VAS score at the end of the study period was 1.7. Nearly all patients were satisfied with the pain management and surgery; no patients received a second opioid prescription. Conclusions: We found that patients consumed far fewer opioid pills than were prescribed to them. We also found that patients who took more opioid pills had higher VAS pain scores, with lower satisfaction in both categories. The cohort demonstrated effective control of pain with high satisfaction, indicating that an opioid protocol is a successful and patient-accepted tool for managing postoperative pain. Type of study/level of evidence: Therapeutic IV.

Keywords

• Hand surgery
• Opioids
• Oxycodone
• Pain management
• Pain protocol