Evaluating Prescriber Adherence to a Standardized Postoperative Opioid Prescription Protocol for Cubital Tunnel Surgery

• DOI: 10.1016/j.jhsg.2024.02.007
• Publication Date: 2024-03-26T06:24:25Z
• Authors: Carew Giberson-Chen; Christina Liu; Phillip Grisdela; David Liu; Zina Model; Amy Steele; Philip Blazar; Brandon E. Earp; Dafang Zhang

PurposeConcerns regarding the ongoing opioid epidemic have led to implementation of standardized postoperative opioid-prescribing protocols for many common hand surgical procedures. This study investigated patient- and procedure-specific factors affecting adherence a protocol after cubital tunnel surgery.MethodsA retrospective review patients who underwent primary surgery within one academic medical system between October 1, 2016 (after protocol) March 2020 was performed. Patients aged <18 years or with history revision surgery, prior traumatic ulnar nerve injury, additional concurrent procedures, surgeon not participating in were excluded. Patient demographics, comorbidities, history, variables recorded. The outcome protocol. A bivariate statistical analysis performed.ResultsNinety-eight included. median initial prescription amount 75 morphine equivalent units (100% target) 78 (80% cohort) situ decompression (50% 20 (20% transposition. Forty-nine percent prescriptions adhered protocol, compared 26% below target above target. In analysis, recent 3 months preoperatively associated improved prescriber adherence; longer tourniquet time anterior transposition target, target.ConclusionsVariation patterns persists despite Recent adherence, possibly reflecting increased provider vigilance this patient population. Differing amounts versus may be unnecessary.Type study/level evidenceTherapeutic IV. Concerns surgery. Ninety-eight Variation unnecessary.