Prospective Evaluation of Opioid Consumption Following Cubital TunnelDecompression Surgery

摘要

Managing postoperative pain is important for patientsand surgeons. However, there is concern over opioid dependency. Cubital tunneldecompression is among the most common upper extremity surgeries. Our studyaimed to analyze opioid use after cubital tunnel decompression to guidepostoperative opioid prescribing. We prospectivelycollected opioid consumption for 16 consecutive months (February 2016 to June2017) for cubital tunnel decompression patients. Data on demographics, insurancetype, surgery performed, functional questionnaires (Quick Disabilities of theArm, 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 morphineequivalent units (MEUs) (range, 0-300), or 7 oxycodone 5-mg pills,postoperatively. Cubital tunnel release (CuTR) patients consumed fewer thanulnar nerve transposition (UNT) patients (40.4 vs 62.5 MEUs or 5.4 vs 8.3 pills, = .08). Patients undergoing submuscular UNT consumed morethan CuTR (115.0 vs 40.4 MEUs or 15.3 vs 5.4 pills, p = 0.003) and more thansubcutaneous UNT patients (37.8 MEU or 5.0 pills, p = 0.03). Medicare patientsconsumed less than privately insured (42.7 vs 54.1 MEUs, 5.7 vs 7.2 pills, = .02) and less than workers’ compensation patients (76.8MEU or 10.2 pills, = .04). Older patients consumed fewer thanyounger patients ( = .03). Postoperative QuickDASH score waspositively related to opioid intake ( = .009). Patients consumed 7 oxycodone 5-mg pills aftercubital tunnel decompression. Younger, privately insured, and workers’compensation patients, and those with worse functional scores and thoseundergoing UNT (specifically the submuscular technique) consumed moreopioids.