{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:31:51Z","timestamp":1777447911701,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rib fracture (RF) pain management provides analgesia while reducing opioids. We postulated: (1) Prescriber factors affect opiate duration, and (2) lidocaine infusion curtails dependency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Retrospective study of RF patients undergoing multimodal analgesia at ACS-verified Level 1 Trauma Center April 2018-February 2020. Exclusions: age&lt;18\u00a0y\/o, GCS &lt; 14, hospital length of stay (LOS) &lt;3\u00a0d, &lt;3 RF, ventilator support, injury-related mortality, disclosed\/discoverable, acute\/chronic opiate Rx within 90\u00a0days preadmission, substance abuse, patient inaccessible via Controlled Substance Monitoring Database (CSMD), and\/or not using opioids in-\/post-hospitalization. CSMD queried regarding opioid prescriptions filled by cohort. Cohort variable analysis performed on SPSS Version 27sf (Armonk, NY: IBM Corp).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>153 patients included \u2013 113 (74%) stopped opiates by 30 days post-discharge (NORx30), 40 (26%) continued beyond 30 days (Rx+). No significant differences in age, gender, ISS, number of RF, bilaterality, flail chest, and discharge disposition. Significant differences included hospital LOS (7.62 NORx30 vs. 10.22 Rx+, p = .02), number of prescribers (1.73 NORx30 vs. 2.98 Rx+, p &lt; .01), average MME\/day during initial 30 days post-discharge (36.7 \u00b1 17 NORx30 vs. 45.4 \u00b1 30.2 Rx+, p = .03), and number of pills (49 \u00b1 38 NORx30 vs. 120 \u00b1 85 Rx+, p &lt; .01). Patients who received lidocaine infusion (LIDO+) had lower MME\/day prescribed (32.24 \u00b1 19.9, p = .03), were younger (61.2 vs. 65.6, p &lt; .01), had more RFs (7.1 vs. 6.05, p = .03), and shorter LOS (7.71 vs 10.2, p = .01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Prescriber attention to MME\/day and number of pills dispensed affects opioid dependency. We recommend 35\u201340 MME\/day with 50 pill\/month limit prescribed by a single provider monitoring patient and CSMD. Early LI offers post-discharge opioid cessation advantage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348221082275","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T12:43:47Z","timestamp":1649940227000},"page":"1459-1466","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Improving Opioid Prescribing Post-Discharge for Trauma Patients With Rib Fractures: Factors in Prevention of Prolonged Use and Dependency"],"prefix":"10.1177","volume":"88","author":[{"given":"Sarah A","family":"King","sequence":"first","affiliation":[{"name":"East Tennessee State University, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Harper","sequence":"additional","affiliation":[{"name":"The University of Tennessee Health Science Center College of Medicine, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lou M","family":"Smith","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Crismon","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E","family":"Heidel","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genevieve","family":"Hall","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Beam","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian J","family":"Daley","sequence":"additional","affiliation":[{"name":"The University of Tennessee Medical Center, Mountain Home, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"bibr1-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199412000-00018"},{"key":"bibr2-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(03)00256-2"},{"key":"bibr3-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1177\/000313480807400406"},{"key":"bibr4-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2019.01.020"},{"key":"bibr5-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2021.05.052"},{"key":"bibr6-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1177\/00031348211050838"},{"key":"bibr7-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239896"},{"key":"bibr8-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-101120"},{"key":"bibr9-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000552538.60632.c6"},{"key":"bibr10-00031348221082275","doi-asserted-by":"publisher","DOI":"10.2165\/10898560-000000000-00000"},{"key":"bibr11-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1093\/bjaed\/mkw008"},{"key":"bibr12-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000633464.81931.28"},{"key":"bibr13-00031348221082275","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-015-3105-6"},{"key":"bibr14-00031348221082275","unstructured":"TN Together. 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