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Postoperative opioid-prescribing practices in otolaryngology: A multiphasic study
Sophia Dang1, Alexander Duffy1, Jonathan C Li1
1Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
The Laryngoscope
|June 22, 2019
Summary
Over half of prescribed opioids for otolaryngology procedures were unused, highlighting a need for better pain management guidelines. This study analyzed opioid use and pain trends to inform future prescribing practices.
Area of Science:
- Otolaryngology
- Pain Management
- Opioid Prescribing
Background:
- Evidence-based guidelines for postoperative pain management in otolaryngology are lacking.
- This study investigates opioid prescription and consumption patterns for common otolaryngologic procedures.
Purpose of the Study:
- To develop evidence-based guidelines for postoperative pain management.
- To analyze opioid prescription and consumption, and pain trends for specific otolaryngologic surgeries.
Main Methods:
- Prospective study of 161 patients undergoing parathyroidectomy/thyroidectomy, parotidectomy, sialendoscopy, or transoral robotic surgery resection (TORS).
- Opioid prescriptions were converted to morphine milligram equivalents (MME).
- Patient opioid usage and pain were tracked from discharge to the first clinic visit.
Main Results:
- Over 56% of the 19,748 MME prescribed were unused.
- Unused MME percentages ranged from 38% for TORS to 67% for sialendoscopy.
- Male gender, smoking history, and psychiatric medication use predicted higher opioid consumption.
Conclusions:
- A significant portion of prescribed postoperative opioids in otolaryngology are unused, particularly for non-mucosal surgeries.
- Minimizing unnecessary opioid prescriptions is crucial for effective postoperative pain management.
- Prescribing recommendations are being developed based on these findings to improve institutional practices.
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