Opioid Education Formats Equally Effective for Postoperative Pain Control

A recent pilot study conducted at the Hospital for Special Surgery (HSS) found that three different educational approaches for patients undergoing total knee arthroplasty (TKA) are equally effective in managing postoperative pain and opioid use. The study compared the institution's standard-of-care webinar with two alternative interventions: in-person education and video-based education. All three methods aimed to enhance patient knowledge about opioid use, pain control, and medication handling.

The study enrolled 42 patients who were randomized into one of the three groups. Researchers evaluated outcomes including opioid refill requests through postoperative days 30 and 60, pain scores, opioid consumption in oral morphine equivalents (OME), and patient-reported practices related to medication storage and disposal. The goal was to determine whether the alternative formats could provide improved outcomes compared to the traditional webinar.

Results showed no statistically significant differences between the groups. Opioid refill requests ranged from 0% to 16.7% at 30 days and from 0% to 8.3% at 60 days post-surgery. Pain scores were consistently five or below across all groups during key postoperative time points, and by day 7, patients in all groups reported average daily opioid consumption of 14 OME or less.

Although the findings suggest that all three educational formats were equally effective, the study's small sample size limits the ability to detect subtle differences between the groups. Researchers emphasized the need for larger trials to confirm these results and further refine educational strategies.

“Overall, patients in each group did well with postoperative pain management after TKA and had minimal opioid refill requests,” the study authors concluded. “There were no statistically significant differences in outcomes of NRS pain scores or opioid usage among groups suggesting that educational interventions were similarly effective.”

Reference
Sheetz M, Puglisi A, Trentalange M, et al. Comparing modalities of opioid education in patients undergoing total knee arthroplasty: a randomized pilot trial. Regional Anesthesia & Pain Medicine. 2024 Sept. 26. doi:10.1136/rapm-2024-105701