Postoperative Opioid Receipt After Parotidectomy and Associations With Persistent Opioid Use Disorder

To investigate the association between postoperative opioid receipt and the development of persistent opioid use disorder following parotidectomy.

Propensity-matched retrospective cohort study.

United States.

The TriNetX Research Network was queried for adult patients who underwent parotidectomy from 2010 to 2023. Patients with a history of opioid abuse/dependence or underwent surgery with anesthesia within 9 months postoperatively were excluded. The opioid cohort included patients that received hydrocodone, oxycodone, or codeine postoperatively, whereas the nonopioid cohort included patients that did not receive these opioids postoperatively. Cohorts were propensity score matched for patient demographics, psychiatric and preoperative pain diagnoses, as well as for possible procedures performed concurrently alongside parotidectomy. The primary outcome was risk of persistent opioid use, defined as new opioid use 3 to 9 months following surgery. Secondary outcomes included the number of emergency department and office/outpatient visits within 1 and 3 months postoperatively and the risk of opioid abuse/dependence.

After propensity matching, each cohort had 3858 patients. The opioid cohort had an increased risk of developing new persistent opioid use (RR = 1.321, P < .001) compared to the nonopioid cohort. Opioid receipt was also associated with increased office/outpatient visits within 1 (P < .001) and 3 months (P < .001). The number of emergency department visits and risk of opioid abuse/dependence were not significantly different between cohorts.

Opioid prescription following parotidectomy was associated with an increased risk of persistent opioid use disorder and the number of postoperative office visits, emphasizing the need for further investigation of opioid-sparing analgesia protocols following parotidectomy.