Postoperative Opioid Use and Pain Management Following Otologic and Neurotologic Surgery.

TitlePostoperative Opioid Use and Pain Management Following Otologic and Neurotologic Surgery.
Publication TypeJournal Article
Year of Publication2020
AuthorsBoyd C, Shew M, Penn J, Muelleman T, Lin J, Staecker H, Wichova H
JournalAnn Otol Rhinol Laryngol
Date Published2020 Feb
KeywordsAnalgesics, Opioid, Cohort Studies, Diagnostic Self Evaluation, Drug Utilization, Female, Humans, Male, Middle Aged, Neurosurgical Procedures, Otologic Surgical Procedures, Pain Management, Pain Measurement, Pain Perception, Pain, Postoperative, Prospective Studies

OBJECTIVES: The topic of prescription opioid overuse remains a growing concern in the United States. Our objective is to provide insight into pain perception and opioid use based on a patient cohort undergoing common otologic and neurotologic surgeries.

STUDY DESIGN: Prospective observational study with patient questionnaire.

SETTING: Single academic medical center.

SUBJECTS AND METHODS: Adult patients undergoing otologic and neurotologic procedures by two fellowship trained neurotologists between June and November of 2018 were included in this study. During first postoperative follow-up, participants completed a questionnaire assessing perceived postoperative pain and its impact on quality of life, pain management techniques, and extent of prescription opioid use.

RESULTS: A total of 47 patients met inclusion and exclusion criteria. The median pain score was 3 out of 10 (Interquartile Range [IQR] = 2-6) with no significant gender differences ( = .92). Patients were prescribed a median of 15.0 (IQR = 10.0-15.0) tablets of opioid pain medication postoperatively, but only used a median of 4.0 (IQR = 1.0-11.5) tablets at the time of first follow-up. Measured quality of life areas included sleep, physical activity, work, and mood. Sleep was most commonly affected, with 69.4% of patients noting disturbances.

CONCLUSIONS: This study suggests that practitioners may over-estimate the need for opioid pain medication following otologic and neurotologic surgery. It also demonstrates the need for ongoing patient education regarding opioid risks, alternatives, and measures to prevent diversion.

Alternate JournalAnn Otol Rhinol Laryngol
PubMed ID31625416
Faculty Reference: 
Helena Wichova, MD