Strong Opioids No Better for Pain After Surgery for Fracture
No difference seen in Numerical Pain Rating Scale mean pain score for patients receiving strong versus mild opioids
THURSDAY, Nov. 18, 2021 (HealthDay News) -- Among patients with surgically managed orthopedic fractures, treatment of pain with strong opioid medication is not superior to milder medication, according to a study published online Nov. 17 in JAMA Network Open.
Deanne E. Jenkin, Ph.D., from the University of South Wales in Sydney, and colleagues conducted a double-blind, superiority, randomized clinical trial at a single-center, major trauma hospital to compare analgesia with strong and mild opioids. Participants were inpatients who had sustained an acute nonpathological fracture of a long bone or the pelvis, patella, calcaneus, or talus who were treated with surgical fixation. One hundred twenty patients were randomly assigned as follows: 59 to strong opioids (mean oral morphine equivalent of 32.9 mg for days 1 to 7) and 61 to mild opioids (mean oral morphine equivalent of 5.5 mg for days 1 to 7).
The researchers found that from days 1 to 7 postdischarge, the mean daily Numerical Pain Rating Scale (NRS) mean pain score was 4.04 and 4.54 in the strong and mild opioid groups, respectively (between-group difference, −0.50; 95 percent confidence interval, −1.11 to 0.12; P = 0.11).
"These findings suggest that ongoing strong opioid use after discharge from the hospital should not be supported," the authors write.