Patient education and engagement in postoperative pain management decreases opioid use following knee replacement surgery.

OBJECTIVE

Effects of patient education on perioperative analgesic utilization are not well defined. We designed a simple pain management educational card for total knee arthroplasty (TKA) patients and retrospectively reviewed clinical data before and after implementation to test the hypothesis that more informed patients will use less opioid.

METHODS

With IRB approval, we analyzed clinical data collected perioperatively on all TKA patients one month before (PRE) and one month after (POST) card implementation. The card was designed using a modified Delphi method; the front explained all analgesic medications and the Defense and Veterans Pain Rating Scale was on the back. The primary outcome was total opioid dosage in morphine milligram equivalents (MME) for the first two postoperative days. Secondary outcomes included daily opioid usage, pain scores, ambulation distance, hospital length of stay and use of antiemetics.

RESULTS

There were 20 patients in each group with no differences in baseline characteristics. Total two-day MME [median (10th-90th percentiles)] was 71 (32-285) for PRE and 38 (1-117) for POST (p = 0.001). There were no other differences.

CONCLUSION

Educating TKA patients in multimodal pain management using a simple tool decreases opioid usage.

PRACTICE IMPLICATIONS: Empowering TKA patients with education can reduce opioid use perioperatively.