{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,30]],"date-time":"2024-12-30T19:11:37Z","timestamp":1735585897919},"reference-count":9,"publisher":"Universa BV","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Orthop Belg"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>The last decade there is an exponential increase in opioid related deaths. This is proven to be correlated with the rising medical prescription rates of strong opioids. We investigated whether pain after hallux valgus surgery under popliteal nerve block could be adequately controlled without the prescription of oral opioids, with a single transdermal fentanyl patch. In this prospective observational study with 100 patients undergoing corrective first metatarsal osteotomies we prospectively investigated the adverse effects and need for extra pain medication. The transdermal fentanyl patch was applied one hour before surgery, prior to the ultrasound guided popliteal nerve block. Patients filled out a questionnaire every 6 hours to evaluate the pain [VAS-score], nausea [PONV-score], activity [acivity and ambulation score] and the intake of extra medication.\n\nPostoperative pain was well controlled [Mean VAS 2,53]. The maximum mean VAS score [3.93] was recorded 36 hours postoperatively. 63.8% of patients had less pain than expected. No major adverse effects were reported by the patients. Nausea was mainly mild and the majority of patients reported \u2018no effect\u2019 or \u2018sometimes\u2019 effect on daily activities.\n\nIn an era where surgeons need to be aware of the threat of overuse of strong opioids, the use of a single transdermal fentanyl patch in combination with an ultrasound guided nerve block can be a good alternative in hallux valgus surgery. The use of the patch seems to obviate the need for oral opioids after discharge. Nausea and vomiting were a concern \u2013 as expected \u2013, but only at 24 and 36 hours. On the other hand nausea did not seem to affect activity, as there was a gradual increase in activity score over time.<\/jats:p>","DOI":"10.52628\/88.3.10258","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T23:40:10Z","timestamp":1676504410000},"page":"575-580","source":"Crossref","is-referenced-by-count":1,"title":["Improving postoperative analgesia in hallux valgus surgery: oral opioids suppression by addition of a single transdermal fentanyl patch: a prospective evaluation"],"prefix":"10.52628","volume":"88","author":[{"given":"Geoffroy","family":"Vandeputte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annelies","family":"Eeckhoudt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Van Opstal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Victor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"27062","published-online":{"date-parts":[[2023,1]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Ballantyne JC, Murinova N, Krashin DL. Opioid guidelines are a necessary response to the opioid Crisis. Clinical Pharmacology & Therapeutics. 2018;103 (6):946-949.","DOI":"10.1002\/cpt.1063"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Kansagra S. M , Cohen M. K. The opioid epidemic in NC: progress, challenges and opportunities. N C Med J 2018;79(3):157-162.","DOI":"10.18043\/ncm.79.3.157"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Kim N., J.L. Matzon, J. Abboudi, C. Jones, W. Kirkpatrick, C. F. Leinberry, F. E. Liss, K. F. Lutsky, M. L Wang, M. Maltenfort, A. M Ilyas. A prospective evaluation of opioid utilization after upper-extremity surgical procedures: identifying consumption patterns and determining prescribing guidelines; J Bone J Surg Am 2016;98 (20):89-94.","DOI":"10.2106\/jbjs.15.00614"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Muijsers RB, Wagstaff AJ. Transdermal fentanyl: An updated Review of its Pharmacological Properties and Therapeutic Efficacy in Chronic Cancer Pain control. Drugs. 2001;61(15):2289-307.","DOI":"10.2165\/00003495-200161150-00014"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Margetts L, Sawyer R. Transdermal drug delivery: principles and opioid therapy. BJA Educ. 2007;7 (5):171-176.","DOI":"10.1093\/bjaceaccp\/mkm033"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Sathitkarnmanee T, Tribuddharat S, Noiphitak K, Theerapongpakdee S, Pongjanyakul S, Huntula Y. et al. Transdermal fentanyl patch for postoperative analgesia in total knee atroplasty: a randomized double-blind controlled trial. J Pain Res 2014;7:449-454.","DOI":"10.2147\/jpr.s66741"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Song JH, Kang C, Hwang DS, Hwang JM, Shin BK. Fentanyl patches to supplement ultrasound-guided nerve blocks for improving pain control after foot and ankle surgery: A prospective study. J Foot Ankle Surg 2016;55 121-124.","DOI":"10.1053\/j.jfas.2015.08.009"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Theisen K, Jacobs B, Macleod L, Davies B. The United States Opioid Epidemic: A Review of the Surgeon\u2019s Contribution and Health Policy Initiatives. BJU Int. 2018; 122(5):754-759.","DOI":"10.1111\/bju.14446"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Van Bastelaere M, Rolly G, Abdullah NM. Postoperative analgesia and plasma levels after transdermal fentanyl for orthopedic surgery: double blind comparison with placebo J Clin Anesth 1995;7(1): 26-30","DOI":"10.1016\/0952-8180(94)00000-t"}],"container-title":["Acta Orthopaedica Belgica"],"original-title":[],"deposited":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T23:40:14Z","timestamp":1676504414000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.actaorthopaedica.be\/archive\/volume-88\/issue-3\/original-studies\/improving-postoperative-analgesia-in-hallux-valgus-surgery-oral-opioids-suppression-by-addition-of-a\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":9,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,1]]},"published-print":{"date-parts":[[2022,9]]}},"URL":"https:\/\/doi.org\/10.52628\/88.3.10258","relation":{},"ISSN":["0001-6462"],"issn-type":[{"value":"0001-6462","type":"print"}],"subject":[],"published":{"date-parts":[[2022,9]]}}}