abstract
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Background. Faced with the current opioid epidemic, alternative methods to managing postoperative pain are being investigated that could eliminate or substantially reduce opioid prescription and use. Prescribing opioids peri- and post-operatively has been shown to trigger chronic abuse independent of previous drug use and increase the risk of long-term use. The postoperative pain experienced in orthopedic surgery is substantial and it is not surprising that the highest incidence of long-term opioid use occurs after total knee and total hip arthroplasty. Despite the numbers of abuse continuing to rise, there remains a need for high quality and reproducible evidence to support protocols that reduce or eliminate opioid prescription. The goal of this scoping review is to identify the current literature and on opioid reduction after orthopedic surgery, 2) describe the interventions used 3) describe the author’s conclusion on opioid use and postoperative outcomes and 4) synthesize the results of included studies to highlight patterns seen with different interventions.Methods. This is a protocol for a scoping review of opioid sparing analgesic strategies that eliminate or significantly reduce opioid prescription after orthopedic surgery. We will include studies of all designs, excluding expert opinions. We will search Cochrane Library, Embase and Medline. Literature will be managed using Rayyan QCRI software. Two reviewers will independently screen the studies for inclusion, and extract information surrounding the effectiveness of alternative strategies and reduction in opioid prescription. Our analysis will be descriptive in nature. We will group studies based on type of orthopedic procedure and nature of intervention used to report study outcomes.Discussion. Our study will consolidate the current literature on opioid-sparing analgesia after orthopedic surgery and describe the effectiveness of current alternative options. It will look to reveal gaps in our knowledge surrounding our current treatment alternatives to establish areas of interest for future research. Registration. This review was registered prospectively on PROSPERO (registration number CRD42020153418).