Prescribing Fewer Tablets Can Cut Post-ACL Surgery Opioid Use

For patients undergoing anterior cruciate ligament reconstruction, prescribing fewer tablets is associated with lower postoperative opioid consumption, according to a research letter published in the issue of the Journal of the American Medical Association.

Kevin X. Farley, from Emory University School of Medicine in Atlanta, and colleagues examined the impact of reducing the number of opioid tablets prescribed among adolescent and adult patients undergoing anterior cruciate ligament reconstruction. Based on the date of surgery, patients were nonrandomly separated into three cohorts to receive 50 tablets of Percocet, 30 tablets, or 30 tablets with an educational session, which outlined appropriate opioid use and alternative pain control strategies (107, 77, and 78 patients, respectively).

The researchers found that patients receiving 50 tablets consumed a mean of 25.4, while those receiving 30 tablets and no education consumed a mean of 15.6. Compared with those receiving 30 tablets and no education, patients receiving 50 tablets took opioids for a significantly greater number of postoperative days (5.8 versus 4.5 days). Compared with those receiving 30 tablets and no education, those receiving 30 tablets and preoperative education consumed a mean of 12.4 tablets and took opioids for significantly fewer days (3.5 days). Cohorts receiving 30 tablets versus 50 tablets had lower rates of self-reported constipation and fatigue.

"Half of prescribed opioids were consumed in each group, suggesting that prescribing even less might further reduce opioid use," the authors write.

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