Regional anesthesia (RA) can be used to manage perioperative pain in treatment of peri-articular elbow fracture fixation. However, the opioid-sparing benefit is not well-characterized. The hypothesis of this study was that RA had reduced inpatient opioid consumption and outpatient opioid demand in patients that had undergone peri-articular elbow fracture surgery.
This study retrospectively reviews inpatient opioid consumption and outpatient opioid demand in all patients ages 18 and older at a single, Level I trauma center undergoing fixation of peri-articular elbow (distal humerus and proximal forearm) fracture surgery (n=418 patients). In addition to RA vs no RA, additional patient and operative characteristics were recorded. Unadjusted and adjusted models were constructed to evaluate the impact of RA and other factors on inpatient opioid consumption and outpatient opioid demand.
Adjusted models demonstrated decreases in inpatient opioid consumption in patients with RA (13.7 estimated oxycodone 5-mg equivalents or OE’s without RA vs 10.4 OE’s with RA from 0-24 hours postop, p=0.003; 12.3 vs 9.2 OE’s from 24-48 hours postop, p=0.045) postop. Estimated cumulative outpatient opioid demand differed significantly in patients with RA (166.1 vs 132.1 OE’s to 6-weeks, p=0.002; and 181 vs 138.6 OE’s to 90-days, p<0.001).
In proximal forearm and distal humerus fracture surgery, RA was associated with decreased inpatient and outpatient opioid demand after adjusting for baseline patient and treatment characteristics. These results encourage utilization of perioperative RA to reduce opioid utilization.

Copyright © 2021. Published by Elsevier Inc.

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