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Are Opioids Necessary in Middle Ear Surgery? Comparing the Transcanal and Postauricular Approach
Geoffrey C Casazza1, Richard K Gurgel2, Hilary C McCrary2
1Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, Virginia.
Summary
Patients undergoing otologic surgery used minimal prescribed opioids, regardless of surgical approach. Surgeons should consider this to reduce narcotic diversion after ear procedures.
Area of Science:
- Otolaryngology
- Pain Management
- Pharmacology
Background:
- Opioid prescribing patterns after otologic surgery require understanding.
- Differences in opioid use between transcanal and postauricular approaches are not well-defined.
Purpose of the Study:
- To analyze opioid prescribing and usage in otologic surgery.
- To compare opioid consumption between transcanal and postauricular surgical approaches.
Main Methods:
- A prospective survey of patients undergoing otologic surgery (excluding mastoid drilling) was conducted.
- Opioid amounts were converted to milligram morphine equivalents (MME).
- Statistical analysis included Mann-Whitney U test and Chi-square testing.
Main Results:
- Fifty-five patients were analyzed; 18 had postauricular incisions.
- Prescribed MME differed (postauricular: 206.4, transcanal: 143; P=.038), but actual MME used did not (postauricular: 37.7, transcanal: 37.5; P=.29).
- No significant differences were found in opioid usage percentage or pain control levels between groups.
Conclusions:
- Patients utilized a small fraction of prescribed opioids in both surgical groups.
- Opioid use and pain control were similar regardless of surgical approach.
- Awareness of these prescribing patterns can help otologic surgeons minimize narcotic diversion.
