title: Opioid consumption following outpatient upper extremity surgery.
abstract: OBJECTIVE
  After elective outpatient upper extremity surgery, patients' need for opioid analgesic medication may be considerably less than typically dispensed. Our goal for this study was to evaluate pain control and quantify the amount of leftover pain medication.
  
  
  METHODS
  We recruited patients scheduled for elective outpatient upper extremity surgery, who met the inclusion criteria, to participate in a phone interview 7 to 14 days after surgery. Information collected included age, gender, procedure performed, analgesic medication and regimen prescribed, satisfaction with pain control, number of tablets remaining, reasons for not taking medication, other analgesic medications used, payer classification, and any adverse drug reactions.
  
  
  RESULTS
  A total of 287 eligible subjects consented to participate. Of these, 36 patients failed phone contact and 1 patient canceled surgery, which left 250 patients who completed the study. Oxycodone, hydrocodone, and propoxyphene accounted for over 95% of the prescription medications, with adequate pain control reported by 230 (92%) patients. Patients most frequently received 30 pills. Patients undergoing bone procedures reported the highest medication use (14 pills), whereas patients undergoing soft tissue procedures reported the lowest use (9 pills). Over half of the subjects reported taking the opioid medication for 2 days or less. Medicare patients consumed significantly less medication (7 pills, P < .05) than patients covered by all other types of insurance. Overall, patients consumed a mean of 10 opioid pills, whereas 19 pills per subject were reported unused, which resulted in 4,639 leftover tablets for the entire cohort.
  
  
  CONCLUSIONS
  Our data show that excess opioid analgesics are made available after elective upper extremity surgery and could potentially become a source for diversion. A prescription of 30 opioid pills for outpatient surgery appears excessive and unnecessary, especially for soft tissue procedures of the hand and wrist.
  
  
  METHODS
  Prognostic I.
authors.affiliation: Des Moines Orthopaedic Surgeons, P.C., West Des Moines, IA 50265, USA. jrodgers@dmos.com
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rodgers
authors.forename: Kimberly
authors.initials: K
authors.lastname: Cunningham
authors.forename: Keely
authors.initials: K
authors.lastname: Fitzgerald
authors.forename: Edward
authors.initials: E
authors.lastname: Finnerty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D011431:Dextropropoxyphene; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006225:Hand / Q000601:surgery*; D006801:Humans; D006853:Hydrocodone; D008875:Middle Aged; D010098:Oxycodone; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D006853:Hydrocodone; D010098:Oxycodone; D011431:Dextropropoxyphene