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Postoperative Analgesia Protocol: A Resident-Led Effort to Standardize Opioid Prescribing Patterns
Charles Meyer1, Jessica Winters1, Rebecca G Brady2
1Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.
The Laryngoscope
|September 7, 2020
Summary
A resident-led initiative successfully standardized postoperative pain management, significantly reducing opioid prescriptions by 26%. This initiative also decreased opioid refills by 49%, demonstrating effective opioid stewardship in academic surgery.
Area of Science:
- Otolaryngology
- Pain Management
- Surgical Practice
Background:
- Variable surgeon prescribing preferences and resident comfort levels create disparities in opioid prescribing.
- Standardization of postoperative pain management is needed to reduce opioid distribution.
Purpose of the Study:
- To implement and evaluate a resident-led initiative to standardize postoperative opioid prescribing practices.
- To reduce overall opioid distribution within an academic surgical department.
Main Methods:
- Retrospective cohort study comparing 12 months before and after protocol implementation.
- Included adult patients undergoing specific otolaryngologic surgeries (tonsillectomy, septoplasty, thyroidectomy, etc.).
- Analyzed total opioid prescription quantities and refill rates.
Main Results:
- Total opioid prescriptions (morphine milligram equivalents) decreased by 26% (P < .0001).
- Opioid refills decreased by 49%, with a 16% reduction in refill quantity (P < .001).
- Significant reductions observed across all procedures, notably thyroid/parathyroid surgery (84% decrease).
Conclusions:
- Resident-led standardization of pain management protocols can significantly reduce opioid prescribing.
- Standardized protocols contribute to effective opioid stewardship in academic surgical settings.
- Individual patient needs remain paramount, but systemic changes yield substantial opioid reduction.
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