AAOS 2026: Multimodal Pain Protocol vs. Hydrocodone-Acetaminophen After Orthopaedic Trauma Surgery .
Comparing a Multimodal Pain Protocol versus Hydrocodone- Acetaminophen After Outpatient Orthopaedic Trauma Surgeries: A Randomized Controlled Trial
Eighty patients with isolated orthopaedic injuries undergoing outpatient orthopaedic trauma surgery were analyzed to receive either a peripheral nerve block with a multimodal pain protocol consisting of ibuprofen, acetaminophen, gabapentin, and oxycodone (n=41) or a peripheral nerve block with hydrocodone-acetaminophen (n=39). The primary outcome of interest was postoperative opioid consumption measured as morphine milligram equivalents (MMEs). Secondary outcomes of interest included patient-reported visual analog pain scores, patient satisfaction, and perceived effectiveness of individual pain management interventions. Outcomes were assessed at 4 and 14 days postoperatively. Overall, the results of the study revealed no statistically significant difference in cumulative MME consumption between the multimodal and monotherapy groups at either 4 days (P=0.36) or 14 days (P=0.62) after surgery, and there were also no differences in pain scores or patient satisfaction. These findings suggest that when peripheral nerve blocks are used, multimodal pain regimens may not significantly reduce opioid consumption compared with opioid monotherapy in outpatient orthopaedic trauma surgery.
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