Increased opioid consumption in diabetics with operative ankle fractures: a retrospective case–control study

Introduction Opioids are commonly used for post-operative pain control. It is known that diabetic patients with ankle fractures will experience prolonged healing, higher risk of hardware failure, and an increased risk of infection. However, the opioid requirements amongst this patient cohort have no...

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Bibliographic Details
Published in:European journal of orthopaedic surgery & traumatology 2019-08, Vol.29 (6), p.1319-1323
Main Authors: Weiner, David A., Murphy, Jordan P., Gwam, Chukwuweike, Loughran, Galvin J., Vulpis, Christian, Milzman, David P., Wisbeck, Jacob M.
Format: Article
Language:English
Subjects:
Analgesics, Opioid - administration & dosage
Analgesics, Opioid - adverse effects
Ankle
Ankle Fractures - epidemiology
Ankle Fractures - surgery
Comorbidity
Diabetes
Diabetes Mellitus - epidemiology
Drug Utilization Review
Female
Fracture Fixation - adverse effects
Fracture Fixation - methods
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Narcotics
Original Article • ANKLE - FRACTURES
Pain Management - methods
Pain Management - statistics & numerical data
Pain, Postoperative - drug therapy
Patients
Postoperative Complications - diagnosis
Postoperative Complications - etiology
Prescription Drug Overuse - prevention & control
Retrospective Studies
Surgical Orthopedics
Traumatic Surgery
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Summary:Introduction Opioids are commonly used for post-operative pain control. It is known that diabetic patients with ankle fractures will experience prolonged healing, higher risk of hardware failure, and an increased risk of infection. However, the opioid requirements amongst this patient cohort have not been previously evaluated. Thus, the purpose of this study is to retrospectively compare opioid utilization amongst ankle fracture patients with and without diabetes mellitus (DM). Methods An IRB approval was obtained for the retrospective review of patients who presented with an ankle fracture and underwent surgery between November 2013 and January 2017. A total of 180 patients (144 without DM, 36 with DM) with a mean age of 50 years (± 18 years) were included. Opioid consumption was quantified utilizing a morphine-milliequivalent conversion algorithm. A repeated measures ANOVA was conducted to compare opioid consumption. A two-tailed p value of 0.05 was set as the threshold for statistical significance. Results Repeated measures ANOVA revealed a statistically significant decrease in total opioid consumption during the 4-month duration ( p  
ISSN:1633-8065
1432-1068
DOI:10.1007/s00590-019-02428-0