Opioid Prescribing Practice and Needs in Thyroid and Parathyroid Surgery
Maisie Shindo1, James Lim2, Enrique Leon2
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland.
JAMA Otolaryngology-- Head & Neck Surgery
|November 14, 2018
Summary
Patients undergoing thyroid and parathyroid surgery require minimal postoperative opioids. Reducing opioid prescriptions significantly decreased administration without increasing patient calls for pain medication.
Area of Science:
- Endocrinology
- Pain Management
- Surgical Oncology
Background:
- The medical community's role in opioid addiction is increasingly recognized.
- Opioid prescribing practices require careful evaluation to mitigate risks.
Purpose of the Study:
- To assess opioid prescribing patterns for thyroid and parathyroid surgery patients.
- To determine actual postoperative opioid needs in endocrine surgery.
- To guide reduction in postoperative opioid administration.
Main Methods:
- Retrospective cohort study of 1765 opioid-naive patients undergoing thyroid and parathyroid surgery.
- Analysis of prescribed opioid quantities in morphine milligram equivalents (MME) and refill data.
- Comparison of prescribing practices before and after a specific date range.
Main Results:
- Significant reductions in prescribed MME were observed across parathyroidectomy, hemithyroidectomy, and total thyroidectomy procedures.
- In late 2017, a substantial percentage of patients were discharged without opioid prescriptions.
- Patients prescribed less than 75.0 MME did not request additional opioid prescriptions, and calls for pain medication remained similar or decreased.
Conclusions:
- Patients undergoing thyroid and parathyroid surgery have minimal need for postoperative opioids.
- Opioid prescribing can be substantially reduced in endocrine surgery without compromising pain management.
- This study provides evidence for optimizing opioid stewardship in head and neck endocrine procedures.
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