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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

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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.

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