Opioid Utilization After Knee Arthroscopy in Adolescents

Abstract

Background: The purpose of this study was to compare the amount of opioids prescribed to the amount of pain medication required following knee arthroscopy in adolescent and young adult patients in order to determine the effectiveness of current pain control practices at a single institution. Methods: Patients 12-35 years of age who underwent knee arthroscopy between May-August 2016 were provided pain control log books in which they were asked to maintain a record of daily pain medication intake. The outcome of the study was defined as the total number of opioids consumed per patient. Results: One hundred patients returned completed logbooks, 56% female and of average (SD) age 17.54 (3.51). The majority of patients underwent a ligament reconstruction or tibial tubercle osteotomy (57%), had a nerve block placed (51%) and had local anesthesia injected (90%). Use of both IV acetaminophen and ketorolac during the perioperative period was also common (41%). Patients were prescribed an average (SD) of 50.98 (12.50) oxycodone pills and 27.10 (11.94) diazepam pills. They reported consuming an average (SD) of 16.52 (13.94) oxycodone pills and 3.64 (5.52) diazepam pills, approximately 32.4% and 13.4% of those prescribed, respectively. Eleven percent never consumed opioids, and only one patient requested a refill during the 21-day postoperative period. Multivariate analysis revealed that increased weight, longer surgery time, and diazepam use were most closely associated with increased opioid consumption. Conclusion: Following knee arthroscopy, adolescent and young adult patients are commonly over-prescribed opioids, consuming on average only approximately one-third of those prescribed.