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Opioid Prescriptions Following Otologic Surgery: A Population-Based Study.

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  • 1Otolaryngology-Head and Neck Surgery, School of Medicine, Queen's University, Kingston, Canada.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 28, 2021
PubMed
Summary

Postoperative opioid prescribing after otologic surgery shows significant variation. Certain procedures like semicircular canal occlusion and mastoidectomy were linked to higher opioid doses, with a notable decrease in overall prescriptions recently.

Keywords:
ear surgeryopioidpain managementperioperative medicinepopulation-based study

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Area of Science:

  • Otolaryngology
  • Pain Management
  • Health Services Research

Background:

  • Opioid prescribing patterns after otologic surgery are not well understood.
  • Variability in postoperative opioid use can impact patient outcomes and contribute to opioid misuse.

Purpose of the Study:

  • To examine postoperative opioid-prescribing patterns following various otologic surgical procedures.
  • To identify factors associated with higher opioid doses prescribed after otologic surgery.

Main Methods:

  • A retrospective, population-based study analyzed data from all Ontario hospitals between 2012 and 2019.
  • Seven cohorts of patients undergoing specific otologic surgeries were identified.
  • Opioid prescriptions were quantified in morphine milligram equivalents (MME), and multivariable regression identified predictors of higher doses.

Main Results:

  • Mean MMEs varied significantly across procedures, with semicircular canal occlusion (SCO) and mastoidectomy associated with higher prescribed doses compared to tympanoplasty with or without ossiculoplasty.
  • Patient comorbidities including asthma, COPD, myocardial infarction, diabetes, and substance-related disorders were linked to increased opioid prescriptions.
  • A notable decline in overall MMEs prescribed was observed between 2017-2018 and 2018-2019.

Conclusions:

  • This study highlights substantial variation and large amounts of opioids prescribed post-otologic surgery.
  • Further research is needed to understand barriers to optimal opioid stewardship in this patient population.
  • Findings underscore the need for refined prescribing guidelines to ensure appropriate pain management while minimizing risks associated with opioid use.