Elimination of extended-release (ER) opioids in the multimodal medication regimen of patients with total knee replacement (TKR) can improve outcomes, including reducing antiemetic use, according to a recent study. Anoush Kalachian, DNP, and colleagues conducted a retrospective chart review to examine an institution’s current postoperative pain protocol and assess whether the elimination of ER opioids in the multimodal medication regimen could improve patient outcomes. The researchers reviewed 60 patients, including 36 patients preprotocol and 24 patients postprotocol. The average age was 70 years. The researchers identified reductions in antiemetic use and length of stay, and an increase in discharges to home versus rehabilitation facility (67% in the postprotocol group vs 53% in the preprotocol group). Upon discharge, all patients received 30 tablets of one opioid prescription with no refill; these included oxycodone-immediate release (82%), hydromorphone (5%), and tramadol (12%). Kalachian and colleagues concluded that the findings support current guidelines that recommend against using extended-release opioids for patients with TKR.