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Area of Science:

  • Otolaryngology
  • Pain Management
  • Pharmacology

Background:

  • Effective pain management after rhinologic surgery is crucial to prevent opioid over-prescription.
  • Data on expected pain and appropriate opioid needs post-rhinologic surgery is scarce.

Purpose of the Study:

  • To systematically review existing literature on pain levels and opioid requirements following rhinologic surgery.
  • To identify factors influencing opioid needs and assess the extent of opioid over-prescription.

Main Methods:

  • A systematic review was conducted following PRISMA guidelines.
  • Searches were performed across major databases including PubMed, Embase, Ovid MEDLINE, and Cochrane Library.
  • Thirteen studies were included after screening 405 articles.

Main Results:

  • Postoperative pain after rhinologic surgery is generally mild to moderate and short-lived (3-6 days).
  • Significant over-prescription of opioids was reported, with excess medications often stored inappropriately at home.
  • Factors like concurrent septoplasty, younger age, and smoking increased opioid requirements.

Conclusions:

  • Rhinologic surgery is associated with manageable, short-term pain, necessitating limited opioid use.
  • Current prescribing practices often exceed actual patient needs, creating risks for opioid misuse, abuse, and diversion.
  • Further high-quality research with standardized pain and prescription reporting is needed due to the predominance of low-level evidence.