Logo image
Back
Thumb Basal Joint Arthroplasty: Prospective Comparison of Perioperative Analgesia and Opioid Consumption
Journal article   Peer reviewed

Thumb Basal Joint Arthroplasty: Prospective Comparison of Perioperative Analgesia and Opioid Consumption

Andrew J. Miller, Michael Livesey, Dennis P. Martin, Jack Abboudi, William H. Kirkpatrick, Frederic E. Liss, Christopher M. Jones, Mark L. Wang, Jonas L. Matzon and Asif M. Ilyas
Orthopedics (Thorofare, N.J.), v 41(3), pp E410-E415
01 May 2018
DOI: https://doi.org/10.3928/01477447-20180409-04
PMID: 29658975

Abstract

Life Sciences & Biomedicine Orthopedics Science & Technology
Trapeziectomy alone or in combination with a suspensionplasty technique is a common surgical treatment for symptomatic thumb basal joint arthritis. The authors undertook a prospective comparative study to test the hypothesis that peripheral nerve blocks would provide better pain control than local anesthesia with bupivacaine or liposomal bupivacaine regarding pain scores and opioid pill consumption. Patients who elected to undergo basal joint arthroplasty were allocated to 1 of 3 postoperative pain management groups: (1) peripheral nerve block, (2) local anesthesia with bupivacaine, or (3) local anesthesia with liposomal bupivacaine. Total opioid pill consumption and visual analog scale pain scores were reported for the first 5 postoperative days (PODs). Seventy-eight patients were enrolled, with 27, 23, and 28 patients in the peripheral nerve block, bupivacaine, and liposomal bupivacaine groups, respectively. All groups experienced an increase in opioid pill consumption and visual analog scale pain scores from POD 0 to POD 1. Postoperative visual analog scale pain scores were lowest in group 3 from POD 0 to POD 2. Average visual analog scale pain scores were highest in group 1, except for on POD 0. After POD 2, visual analog scale pain scores normalized between all groups and decreased uniformly thereafter. Total opioid consumption was lowest in group 3 (average, 11 pills) compared with group 1 (average, 17 pills) and group 2 (average, 19 pills). Overall, these findings did not support the authors' hypothesis that peripheral nerve blocks are superior in terms of postoperative pain control and opioid consumption. Although there were advantages regarding opioid consumption and pain control with liposomal bupivacaine, these were limited to the first POD. The effectiveness of each modality, as well as potential risks and costs, should be considered when determining the optimal strategy.

Metrics

13 Record Views
4 citations in Web of Science
4 citations in Scopus

Details

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Logo image