Pain control is comparable between opioid versus non‐opioid management after otolaryngology procedures

Author:

Sarathy Ashwini1ORCID,An Clemens1,Bever Ty1,Callas Peter2,Fujii Mayo H.2,Sajisevi Mirabelle3ORCID

Affiliation:

1. Larner College of Medicine University of Vermont Burlington Vermont USA

2. Department of Surgery University of Vermont Medical Center Burlington Vermont USA

3. Department of Otolaryngology University of Vermont Medical Center Burlington Vermont USA

Abstract

AbstractObjectiveThe current study aims to measure patient‐reported satisfaction with pain control using opioid and non‐opioid medications after undergoing the following otolaryngology procedures: parathyroidectomy, thyroid lobectomy, total thyroidectomy, and bilateral tonsillectomy.Materials and MethodsA prospective cohort study was performed at an academic medical center that included a telephone questionnaire and chart review. Opioid prescriptions, usage, and patient‐reported pain outcomes were recorded. Bivariate analyses were used to compare opioid and non‐opioid users.ResultsOf the 107 total patients undergoing otolaryngology procedures included in the study, 49 (45.8%) used an opioid for pain management postoperatively and 58 (54.2%) did not. Among the 81 patients who underwent endocrine procedures (parathyroidectomy, total thyroidectomy/lobectomy), most patients reported being “very satisfied” or “satisfied” with pain control whether they used opioids (n = 27/30, 90%) or not (n = 50/51, 98%). Of the 26 patients who underwent bilateral tonsillectomy, 19 (73%) were prescribed opioids and among these, most (n = 17/19, 89%) reported they were “very satisfied” or “satisfied” with pain control. In the non‐opioid usage group, all patients (n = 7/7, 100%) reported they were “satisfied” with pain control. There was no statistically significant difference in patient‐reported satisfaction with pain control between opioid and non‐opioid users for any of the procedures listed.ConclusionThe results of our study suggest that patients who did not use opioids have a similar level of satisfaction with pain control compared to those using opioids after thyroid, parathyroid and tonsillectomy surgeries. Considering the magnitude of the opioid crisis, providers should reassess the need for opioid prescriptions following certain ENT procedures.Level of EvidenceIV.

Publisher

Wiley

Reference16 articles.

1. Trends and Patterns of Geographic Variation in Opioid Prescribing Practices by State, United States, 2006-2017

2. Monthly Opioid Morbidity and Mortality Report.Vermont Department of Health.https://www.healthvermont.gov/sites/default/files/documents/pdf/ADAP-MonthlyOpioidRelatedFatalOverdoses.pdfAccessed March 1 2023.

3. Opioid Stewardship in Otolaryngology: State of the Art Review

4. Opioid Prescribing Patterns among Otolaryngologists

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