![]() ![]() “Patients rely on their surgeon to tell them what kind of pain medication they need after surgery. ![]() Donald Lalonde, professor in the Department of Plastic Surgery at Dalhousie University who practices in Saint John, N.B., this randomized, international study included researchers from Western University University of Michigan Health System Virginia Tech Carilion School of Medicine Sanford School of Medicine at the University of South Dakota and McGill University. “This makes us even more confident that the over-the counter pain relief medication was not inferior.” “Not only were (over-the-counter medicines) not inferior… but the direction of the difference was actually that the patients taking the opioids actually had a little bit worse pain score on the first night after surgery,” said MacDermid, who was a co-author of the study. To be clinically significant, there would have to be at least a two-point difference between the groups, but it was still a surprising outcome for the research team. ![]() The highest recorded difference between the opioid and the over-the-counter groups was on the night of the surgery, when patients taking opioids had 0.9/10 points worse pain than those taking over-the-counter medication. The researchers found no significant differences between opioid and over-the-counter in terms of the numeric pain rating scale scores, pain interference scores, number of doses of medication, or patient satisfaction. Using the numeric pain rating scale (0 to 10) and the six-item pain interference scale, the participants’ pain scores were measured at multiple times per day for seven days following the surgery. The participants had all undergone carpal tunnel release procedure and were not previously taking daily opioid pain medication prior to surgery. The study involved 347 patients enrolled across five centres in Canada and the U.S., including 92 patients from The Hand and Upper Limb Centre at St Joseph’s Health Centre. James Roth Chair in Musculoskeletal Measurement and Knowledge Translation and Canada Research Chair in Musculoskeletal Health Outcomes and Knowledge Translation. The study, published in the American Society of Plastic Surgeons, may provide clinicians and patients a level of confidence that over-the-counter pain medicines like ibuprofen or acetaminophen are not inferior to prescription opioids, said Western professor Joy MacDermid, a researcher at Western’s Bone and Joint Institute, the Dr. A new North American study has found over-the-counter medications are just as effective as opioids for patient pain management following carpal tunnel surgery. ![]()
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