Regional anesthesia (RA) has been utilized to minimize pain and narcotic usage after hip fracture surgery. Despite possible analgesic advantages, little is known about the impact of RA on inpatient and outpatient opioid demand. Researchers expected that RA would reduce inpatient opioid demand while not influence outpatient opioid demand in hip fracture surgery.
The study looked back at all patients aged 18 and above who had hip fracture surgery at a single level I trauma center between July 2013 and July 2018 (n=1,659). Inpatient opioid intake was documented in 24-hour increments up to 72-hour postoperatively, and outpatient opioid prescribing was tracked up to 90-day postoperatively in oxycodone 5-mg equivalents (OE’s). After controlling for other baseline and treatment factors, adjusted models assessed the influence of RA on opioid demand.
After controlling for baseline and treatment variables, there was a small increase in inpatient opioid consumption in RA patients (2.6 estimated OE’s without RA versus three OE’s with RA from 0 to 24 hours postoperatively, 2.1 versus 2.4 from 24 to 48 hours postoperatively, and 1.6 versus 2.2 from 48 to 72 hours postoperatively, all P values for RA<0.001). Outpatient opioid demand, on the other hand, showed no discernible variations.
In the pragmatic trial, RA did not affect inpatient or outpatient opioid demand in hip fracture surgery patients. In fact, there was a modest rise in inpatient opioid intake, albeit the differences were most likely clinically unimportant.