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Opioid-Sparing Protocol for Endocrine Surgery (OSPREY): A Prospective Study.

Maxwell P Kligerman^1,2, Joaquin Austerlitz^1,3, Lisa A Orloff¹

¹From the Department of Otolaryngology/Head and Neck Surgery, Stanford University, Stanford, CA (Kligerman, Austerlitz, Orloff, Noel).

Journal of the American College of Surgeons

|June 7, 2023

Summary

An opioid-sparing protocol using acetaminophen and ibuprofen after thyroid surgery reduced opioid use without impacting pain scores. Further randomized trials are needed to confirm these findings for enhanced postoperative pain management.

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Area of Science:

Surgical Outcomes
Pain Management
Pharmacology

Background:

Thyroid and parathyroid surgeries are common worldwide.
There is a lack of prospective trials on opioid-sparing protocols post-surgery.

Purpose of the Study:

To evaluate the efficacy of an opioid-sparing protocol versus a standard opioid protocol after thyroid and parathyroid surgery.

Main Methods:

Prospective nonrandomized study with 87 participants.
Two arms: opioid-sparing (acetaminophen/ibuprofen) and treatment-as-usual (opioids).
Primary endpoints: Overall Benefit of Analgesia Scores (OBAS) and opioid use.

Main Results:

Opioid-sparing group used significantly fewer opioids (p=0.042).
No significant difference in OBAS between groups (p=0.37).
Multivariable analysis showed no difference in OBAS when controlling for covariates (p=0.88).

Conclusions:

Opioid-sparing protocols with acetaminophen/ibuprofen may be safe and effective.
Further randomized, adequately powered studies are necessary to validate these results.