Category: Orthopedics
Posted: 7/27/2025 by Brian Corwell, MD
(Updated: 12/5/2025)
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A recent study investigated the impact of pain management education counseling on postoperative opioid consumption.
Patients were randomly assigned to receive opioid limiting perioperative pain management education and counseling (intervention group) with instructions to take opioids “only as a last resort if the pain became unbearable.”
The control group received instructions to take opioids as needed for “severe pain” to” stay ahead of the pain.”
The primary outcome was the total morphine equivalents (TME) consumed in the 3 months after surgery.
Secondary outcomes included pain measured with the Numeric Rating Scale, sleep quality, opioid prescription refills, and patient satisfaction.
121 patients with a mean age of 29 years.
Both groups were told about potential adverse effects of opioids and were advised of alternative methods to control pain such as over-the-counter acetaminophen and ibuprofen.
60 patients in the treatment group consumed a mean of 46 mg TME versus 63.6 mg TME in the control group ( p < 0.001). There was no difference in the average score on the numeric rating scale in the first 14 days between groups. There was no significant difference in refill prescriptions between the groups. Sleep quality and patient satisfaction was also similar between groups.
Over 1/3 of patients in the intervention group took no opioids at all after surgery. In contrast, 9 out of 10 patients in the control group used all prescribed opioids after surgery.
Conclusion: Opioid limiting pain management education and counseling reduces opioid consumption without a change in reported pain. There may be a role for pain management education and counseling in emergency department patients in whom opiates are prescribed…similar to this study in perioperative orthopedic patients.
Packer, Jonathan D. MD1,a; Aneizi, Ali MD1; Honig, Evan L. BS1; Kaveeshwar, Samir MD1; Schneider, Matheus MD1; Leong, Natalie L. MD1; Meredith, Sean J. MD1; O’Hara, Nathan N. PhD, MHA1; Henn, R. Frank III MD1. Perioperative Opioid Counseling for Patients Undergoing Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. The Journal of Bone and Joint Surgery 107(14):p 1546-1552, July 16, 2025
