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How Much Opioid Medication Do Patients Need After Orthognathic Surgery?
Bradley Bousquet1, Mark A Green2, Catherine Noonan Caillouette3
1DMD Candidate, Harvard School of Dental Medicine, Boston, MA.
Summary
Opioid use following orthognathic surgery was quantified, revealing lower-than-expected consumption. Responsible prescribing practices are crucial to prevent overprescribing of analgesics after these procedures.
Area of Science:
- Oral and Maxillofacial Surgery
- Pain Management
- Public Health
Background:
- Opioid misuse represents a significant public health challenge.
- Surgeons must understand analgesic needs for procedures to promote responsible opioid prescribing.
- Orthognathic surgery involves complex procedures with potential for significant postoperative pain.
Purpose of the Study:
- To quantify total opioid consumption in patients undergoing orthognathic surgery.
- To identify factors influencing opioid requirements after orthognathic surgery.
- To inform evidence-based opioid prescribing guidelines for orthognathic procedures.
Main Methods:
- Prospective cohort study of patients undergoing orthognathic surgery (May 2020-September 2021).
- Inclusion criteria: Le Fort I osteotomy, bilateral sagittal split osteotomies, or both. Exclusion criteria: craniofacial syndromes (excluding cleft lip/palate).
- Opioid use measured via electronic health records (inpatient) and daily electronic questionnaires (outpatient) for 7 days post-surgery.
Main Results:
- 91% of 35 patients used opioids postoperatively, with a mean total use of 18.2 ± 20.9 MME/subject.
- 26% of patients receiving inpatient opioids did not use them after discharge.
- Le Fort I osteotomy alone was associated with lower opioid use, while combined procedures had higher requirements. Procedure and hospital stay length predicted analgesic need.
Conclusions:
- Postoperative opioid use following orthognathic surgery appears to be less than anticipated.
- Clinical factors such as procedure type, duration, and length of hospital stay influence opioid consumption.
- Careful consideration and monitoring are necessary to avoid overprescribing opioids after orthognathic surgery.
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