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Prospective Evaluation of Opioid Consumption Following Cubital Tunnel Decompression Surgery
Journal article   Open access   Peer reviewed

Prospective Evaluation of Opioid Consumption Following Cubital Tunnel Decompression Surgery

Bryan A Hozack, Jack Abboudi, Gregory Gallant, Christopher M Jones, William Kirkpatrick, Frederic E Liss, Michael Rivlin, T Robert Takei, Mark L Wang, Matthew Silverman, …
Hand (New York, N.Y.), v 14(1), pp 42-47
01 Jan 2019
DOI: https://doi.org/10.1177/1558944718800732
PMID: 30269520
url
https://doi.org/10.1177/1558944718800732View
Published, Version of Record (VoR) Open

Abstract

Acetaminophen - administration & dosage Adult Age Factors Aged Aged, 80 and over Analgesics, Opioid - administration & dosage Cubital Tunnel Syndrome - surgery Decompression, Surgical Disability Evaluation Drug Combinations Drug Utilization - statistics & numerical data Humans Hydrocodone - administration & dosage Insurance, Health - statistics & numerical data Medicare - statistics & numerical data Middle Aged Oxycodone - administration & dosage Pain, Postoperative - prevention & control Prospective Studies Ulnar Nerve - surgery United States Workers' Compensation - statistics & numerical data Young Adult
Managing postoperative pain is important for patients and surgeons. However, there is concern over opioid dependency. Cubital tunnel decompression is among the most common upper extremity surgeries. Our study aimed to analyze opioid use after cubital tunnel decompression to guide postoperative opioid prescribing. We prospectively collected opioid consumption for 16 consecutive months (February 2016 to June 2017) for cubital tunnel decompression patients. Data on demographics, insurance type, surgery performed, functional questionnaires (Quick Disabilities of the Arm, Shoulder and Hand [QuickDASH]), and electrodiagnostics (electromyography) were collected. Opioid consumption was reported at first postoperative visits. One hundred patients consumed a mean of 50 morphine equivalent units (MEUs) (range, 0-300), or 7 oxycodone 5-mg pills, postoperatively. Cubital tunnel release (CuTR) patients consumed fewer than ulnar nerve transposition (UNT) patients (40.4 vs 62.5 MEUs or 5.4 vs 8.3 pills, P = .08). Patients undergoing submuscular UNT consumed more than CuTR (115.0 vs 40.4 MEUs or 15.3 vs 5.4 pills, p = 0.003) and more than subcutaneous UNT patients (37.8 MEU or 5.0 pills, p = 0.03). Medicare patients consumed less than privately insured (42.7 vs 54.1 MEUs, 5.7 vs 7.2 pills, P = .02) and less than workers' compensation patients (76.8 MEU or 10.2 pills, P = .04). Older patients consumed fewer than younger patients ( P = .03). Postoperative QuickDASH score was positively related to opioid intake ( P = .009). Patients consumed 7 oxycodone 5-mg pills after cubital tunnel decompression. Younger, privately insured, and workers' compensation patients, and those with worse functional scores and those undergoing UNT (specifically the submuscular technique) consumed more opioids.

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