New Randomized Trial Finds New Approach to Pain Management: JAMA Publication Alert.
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Critical appraisals of the latest, high-impact randomized controlled trials and systematic reviews in orthopaedics
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Aaron Gazendam
FRCSC, MSc
Surgeon-Investigator, University of Toronto
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This episode examines the NO PAin trial, a resident-led randomized study testing a multimodal, opioid-sparing strategy after shoulder and knee arthroscopy. Using naproxen, acetaminophen, small rescue opioid prescriptions, and clear patient education, the approach cut postoperative opioid use dramatically—median zero MME versus 40 MME—without worsening pain, satisfaction, or refill rates. Surgeons prescribed far fewer opioids, patients used fewer, and side effects were lower than standard care. The team highlights how low-cost, well-designed trials can shift practice and sees opportunities to extend this model across other surgical fields.
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