Opioid Use After Elective Otolaryngologic Surgery at a Teaching Institution

Area of Science:

• Otolaryngology
• Pain Management
• Opioid Stewardship

Background:

• The opioid epidemic necessitates improved opioid stewardship in healthcare.
• Multimodal nonopioid pain management is effective for many general surgery and gynecology procedures.
• Opioid prescribing patterns in otolaryngology require investigation.

Purpose of the Study:

• To characterize postoperative pain and opioid use in otolaryngology procedures.
• To analyze opioid prescribing patterns at a tertiary hospital.
• To identify discrepancies between prescribed and utilized opioid quantities.

Main Methods:

• Cross-sectional study with patient surveys in an academic otolaryngology practice.
• Inclusion of 3,152 adult patients undergoing 41 common procedures (2013-2017), excluding malignancy.
• Telephone surveys using a standardized questionnaire for patients who had surgery in 2017.

Main Results:

• 95.7% of patients received opioid prescriptions, with a median of 30 pills prescribed per surgery.
• Patient opioid utilization varied by surgery type, being highest for parotid and tonsillectomy, lowest for laryngoscopy, thyroid, and otologic surgery.
• A significant portion of prescribed opioids were unused (19.6% not obtained, 58.4% partially or not used), with poor disposal practices (10.8%).

Conclusions:

• Opioid prescription quantities do not correlate with actual patient analgesic use in elective otolaryngology surgeries.
• Postoperative analgesic requirements differ significantly across various otolaryngology procedures.
• Tailoring opioid prescriptions to individual surgical needs is crucial for effective pain management and reducing opioid dependence.