Alleviation of Pain After Femur and Tibia Shaft Fractures Using Nothing Stronger Than Codeine and Tramadol.

Abstract:

OBJECTIVE:To determine whether using nothing stronger than codeine and tramadol provides adequate pain alleviation in people recovering from fixation of a fracture of the femur or tibia shaft. DESIGN:Retrospective case series. SETTING:Level 1 trauma center in the United States. PATIENTS:All adult patients from October 2016 to October 2018 with femur (OTA/AO 32) and tibial (OTA/AO 42) shaft fractures who were treated surgically were included. A nurse counseled patients on safe and effective alleviation of pain. Charts were reviewed for pain medication prescribed, noting utilization of schedule II opioid medications. MAIN OUTCOME MEASURES:Frequency of schedule II pain medication prescription on discharge or during follow-up, emergency department presentation for pain, or readmission for pain. RESULTS:One hundred fifty patients with 162 fractures were treated for femoral (N = 73 fractures) or tibial (N = 89 fractures) shaft fractures. Sixty patients (40%) were multiple injured patients. Thirteen (8.7%) patients were discharged with hydrocodone, oxycodone, or fentanyl. Of the remaining patients with adequate follow-up (N = 109), 6.4% requested hydrocodone, oxycodone, or fentanyl after discharge. There was 1 patient presentation to the emergency department for pain, and there were no pain-related readmissions. CONCLUSIONS:Alleviation of pain can be achieved in most patients with femoral and tibial shaft fractures, including multiply injured patients, with one-on-one patient support and by using nothing stronger than codeine and tramadol. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

journal_name

J Orthop Trauma

authors

Reich MS,Klahs KJ,Fernandez I,Nguyen MP

doi

10.1097/BOT.0000000000001683

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

e56-e59

issue

2

eissn

0890-5339

issn

1531-2291

pii

00005131-202002000-00011

journal_volume

34

pub_type

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