Author Interviews, Orthopedics, Pain Research / 19.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47992" align="alignleft" width="122"]Geoffrey Westrich, MDDirector of ResearchAdult Reconstruction and Joint Replacement ServiceHospital for Special SurgeryNYC Dr. Westrich[/caption] Geoffrey Westrich, MD Director of Research Adult Reconstruction and Joint Replacement Service Hospital for Special Surgery NYC  MedicalResearch.com: What is the background for this study? Response: Recent mortality trends in the U.S. associated with opioid use disorders have brought to the forefront of national debate the desirability of minimizing the use of potentially addictive pain management therapies.  Pain management after hip replacement surgery is an important part of patient care, and  opioids are frequently given as a major part of postoperative pain management. At the same time, multimodal analgesia, the administration of anesthetic agents and medications agents targeting multiple pain pathways, has seen increased popularity in pain management after hip replacement surgery.  At Hospital for Special Surgery (HSS), the multimodal protocol entails the use of several different anesthetic agents and medications both during and after surgery to control pain, minimize the use of opioids and reduce side effects. The use of non-opioid analgesics such as acetaminophen allows for a reduction in opioid administration after surgery [1]. Acetaminophen, commonly known as Tylenol, has traditionally been administered orally, but more recently an intravenous (IV) preparation has become available.  IV acetaminophen after major orthopedic surgery was shown to provide effective analgesia and reduce morphine administration by 33%, compared to placebo [2]. Unless a patient is unable to take acetaminophen, it is commonly used as part of the multimodal protocol due to its efficacy and minimal contraindications. Although intravenous (IV) acetaminophen presents pharmacokinetic benefits, such as increasing both serum blood and cerebrospinal fluid levels more rapidly, there is limited analysis of its potential clinical advantages compared to oral acetaminophen.  We hypothesized that there could be a reduction in pain with activity, opioid usage, or opioid- related side effects among patients receiving IV acetaminophen compared to oral acetaminophen following hip replacement surgery 
Author Interviews, Opiods, Orthopedics / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47877" align="alignleft" width="130"]Paul Cagle, Jr. MDAssistant Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Cagle[/caption] Paul Cagle, Jr. MD Assistant Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings ie What are some of the significant comorbidities?  Response: In this study our goal was to better understand what medical issues (medical comorbidities) can cause trouble or issue for patients with a proximal humerus fracture (shoulder fracture).  To tackle this issue we used a large national sample of patients and sorted our the different medical issues the patients had. We found that patients with increased medical issues had longer hospital stays and higher use of opioid medications (pain medications).
Author Interviews, Opiods, Orthopedics, Surgical Research / 18.03.2019

MedicalResearch.com Interview with: [caption id="attachment_47736" align="alignleft" width="130"]Dr. Alexis Colvin, MDAssociate Professor of Orthopedic SurgeryIcahn School of Medicine at Mount Sinai Dr. Colvin[/caption] Dr. Alexis Colvin, MD Associate Professor of Orthopedic Surgery Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? Response: 40% of all opioid overdose deaths involve a prescription opioid and orthopaedic surgeons are the 3rd highest prescribers of opioids.  Set guidelines for post surgery opioid prescriptions have not been established.  Arthroscopic knee meniscectomy is one of the most common orthopaedic procedures.  The purpose of this study was to determine how many opioids were being prescribed  among a group of six sports fellowship trained orthopaedic surgeons versus how many patients were actually using.