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Opioid prescribing patterns within otolaryngology.

Alexander W Murphey1, Suqrat Munawar1, Shaun A Nguyen1

  • 1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC, 29425, USA.

World Journal of Otorhinolaryngology - Head and Neck Surgery
|July 24, 2019
PubMed
Summary

Opioid prescribing for otolaryngology procedures shows high variability, particularly for painful surgeries. Standardized post-operative narcotic guidelines are needed to ensure consistent patient care and reduce overuse.

Keywords:
NarcoticsOpioidsOtolaryngology

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Area of Science:

  • Otolaryngology-Head and Neck Surgery
  • Pain Management
  • Pharmacology

Background:

  • Opioid prescribing practices in Otolaryngology-Head and Neck Surgery lack standardization.
  • Variability in post-operative narcotic prescriptions can lead to inconsistent patient outcomes and potential misuse.

Purpose of the Study:

  • To assess current opioid prescribing patterns for adult procedures within an academic Otolaryngology-Head and Neck Surgery training program.
  • To establish a general guideline and promote a more uniform approach to narcotic prescribing.

Main Methods:

  • A prospective, single-center pilot study utilizing an anonymous online survey.
  • Survey distributed to residents, fellows, attending surgeons, and advanced practice providers (APP) in Otolaryngology-Head and Neck Surgery.
  • Data collected on demographics, analgesic preferences, and average opioid tablet counts for common adult procedures.

Main Results:

  • Forty-two participants responded, with hydrocodone-acetaminophen being the most prescribed opioid (83.3%).
  • Tonsillectomy/uvulopalatopharyngoplasty procedures had the highest average opioid prescription (32.3 tablets), while direct laryngoscopy had the lowest (4.8 tablets).
  • Attending physicians prescribed significantly more opioid tablets for septoplasty compared to residents (20 vs. 14.1, P=0.034).

Conclusions:

  • Significant variability exists in current opioid prescribing patterns within Otolaryngology, especially for more painful procedures.
  • There is a clear need for the establishment of standardized post-operative narcotic guidelines in Otolaryngology-Head and Neck Surgery.