Strong vs. Weak Opioids For Outpatient Analgesia After Surgically Managed Fractures .
Effectiveness of Oxycodone Hydrochloride (Strong Opioid) vs Combination Acetaminophen and Codeine (Mild Opioid) for Subacute Pain After Fractures Managed Surgically: A Randomized Clinical Trial.
JAMA Netw Open . 2021 Nov 1;4(11):e2134988.One hundred and twenty patients undergoing surgical fixation of fractures were randomized to receive a strong opioid (Oxycodone, n=59) or a weak opioid (Acetaminophen and codeine, n=61) at the time of discharge from hospital. The primary outcome of interest was mean pain scores for the first week after discharge from hospital as measured by the Numerical Pain Rating Scale (NPRS). Secondary outcomes were pain scores over the first 21 days post-discharge, quality of life as measured by the EuroQoL-5-Dimension 5-Level Questionnaire (EQ-5D-5L), total opioid consumption, adverse events and global perceived effect. There was no difference in pain scores at any time point. The strong opioid group consumed 6 times the amount of oral morphine equivalents during the first 7 days. No differences in any other secondary outcomes were found.
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