Spine surgery patients prescribed the most postoperative narcotics

(HealthDay)—Spine surgery patients are prescribed the most narcotics in the three months following surgery, and patient-reported pain at hospital discharge is associated with increased narcotic use in this period, according to a study published in the July 1 issue of the Journal of the American Academy of Orthopaedic Surgeons.

Nina Fisher, M.D., from NYU Langone Orthopedic Hospital in New York City, and colleagues used electronic medical records to identify 5,030 patients undergoing orthopedic trauma, spine, and adult reconstruction procedures between 2012 and 2015. The authors examined associations between patient-reported pain scores at discharge and narcotic use during the 90-day postoperative period.

The researchers found that spine patients had the longest length of stay, experienced the highest mean pain during length of stay, and were prescribed the most morphine in the 90-day postoperative period. Pain scores at discharge markedly impacted the quantity of narcotics prescribed in the 90-day postoperative period.

"We're performing surgeries to alleviate pain, so it's important to have a greater understanding of high-risk populations to help orthopedic surgeons safely address pain management following surgery," a coauthor said in a statement. "We can obtain a pain management consult before discharge to lower their visual analog scale pain score or use a multimodal analgesia protocol (a regimen of nonopioids and anesthesia to minimize the use of perioperative opioids) during surgery."

One author disclosed financial ties to Exactech.