Theresa Tharakan1, Sydney Jiang2, Judd Fastenberg2, Thomas J Ow1,2,3, Bradley Schiff2, Richard V Smith2, Vikas Mehta2. 1. 1 Albert Einstein College of Medicine, Bronx, New York, USA. 2. 2 Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, USA. 3. 3 Department of Pathology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
Abstract
OBJECTIVES: To examine opioid-prescribing patterns after endocrine surgery. To evaluate factors associated with postoperative pain and opioid use. STUDY DESIGN: Cross-sectional. SETTING: Academic university health system. SUBJECTS AND METHODS: The study sample included 209 patients who underwent total thyroidectomy, hemithyroidectomy, or parathyroidectomy by 4 surgeons between August 2015 and November 2017. Eighty-nine patients completed a phone survey about postoperative pain and opioid use. Prescription, demographic, and comorbidity data were collected retrospectively. Patient characteristics associated with opioid use, use of ≥10 opioid pills, and pain score were identified via chi-square, t test, analysis of variance, or Pearson correlation. Identified factors were further assessed with multivariable logistic and linear regression modeling. RESULTS: The median numbers of opioid pills prescribed were 20 for total thyroidectomy, 25 for hemithyroidectomy, and 20 for parathyroidectomy, and the median numbers of pills used were 1.5, 2, and 0, respectively. Of 1947 total prescribed pills, 19.7% were reported to be taken. The number of pills meeting the opioid needs of 80% of these patients was 10. In multivariable analyses, older age was associated with lower odds of opioid use (odds ratio, 0.97; 95% CI, 0.94-0.999; P = .04) and lower pain scores (Pearson correlation coefficient, -0.05; 95% CI, -0.10 to 0.001, P = .04). Charlson Comorbidity Index score >5 was associated with use of ≥10 pills (odds ratio, 6.62; 95% CI, 1.60-27.50; P = .01). CONCLUSION: Excess opioids are often prescribed for endocrine surgery. By using an ideal pill number and understanding predictors of postoperative pain, surgeons can more adequately treat pain and limit excess opioid prescriptions.
OBJECTIVES: To examine opioid-prescribing patterns after endocrine surgery. To evaluate factors associated with postoperative pain and opioid use. STUDY DESIGN: Cross-sectional. SETTING: Academic university health system. SUBJECTS AND METHODS: The study sample included 209 patients who underwent total thyroidectomy, hemithyroidectomy, or parathyroidectomy by 4 surgeons between August 2015 and November 2017. Eighty-nine patients completed a phone survey about postoperative pain and opioid use. Prescription, demographic, and comorbidity data were collected retrospectively. Patient characteristics associated with opioid use, use of ≥10 opioid pills, and pain score were identified via chi-square, t test, analysis of variance, or Pearson correlation. Identified factors were further assessed with multivariable logistic and linear regression modeling. RESULTS: The median numbers of opioid pills prescribed were 20 for total thyroidectomy, 25 for hemithyroidectomy, and 20 for parathyroidectomy, and the median numbers of pills used were 1.5, 2, and 0, respectively. Of 1947 total prescribed pills, 19.7% were reported to be taken. The number of pills meeting the opioid needs of 80% of these patients was 10. In multivariable analyses, older age was associated with lower odds of opioid use (odds ratio, 0.97; 95% CI, 0.94-0.999; P = .04) and lower pain scores (Pearson correlation coefficient, -0.05; 95% CI, -0.10 to 0.001, P = .04). Charlson Comorbidity Index score >5 was associated with use of ≥10 pills (odds ratio, 6.62; 95% CI, 1.60-27.50; P = .01). CONCLUSION: Excess opioids are often prescribed for endocrine surgery. By using an ideal pill number and understanding predictors of postoperative pain, surgeons can more adequately treat pain and limit excess opioid prescriptions.
Authors: D Wittekindt; C Wittekindt; G Schneider; W Meissner; O Guntinas-Lichius Journal: Eur Arch Otorhinolaryngol Date: 2011-12-01 Impact factor: 2.503
Authors: Irene Lou; Todd B Chennell; Sarah C Schaefer; Herbert Chen; Rebecca S Sippel; Courtney Balentine; David F Schneider; Jacob Moalem Journal: Ann Surg Oncol Date: 2017-02-03 Impact factor: 5.344
Authors: Michael Sommer; José W J M Geurts; Bjorn Stessel; Alfons G H Kessels; Madelon L Peters; Jacob Patijn; Maarten van Kleef; Bernd Kremer; Marco A E Marcus Journal: Arch Otolaryngol Head Neck Surg Date: 2009-02
Authors: Alexander H Gunn; Nicholas Frisco; Samantha M Thomas; Michael T Stang; Randall P Scheri; Hadiza S Kazaure Journal: Thyroid Date: 2021-12-03 Impact factor: 6.568
Authors: Amr F Hamour; Frederick Laliberte; Jordan Levy; Jason Xu; Edward Park; Vincent Lin; John de Almeida; Julie Strychowsky; Antoine Eskander; Eric Monteiro Journal: World J Otorhinolaryngol Head Neck Surg Date: 2022-03-09
Authors: Jennifer P March; James Y Lim; Katherine L Manzione; Michelle Buncke; Maisie L Shindo Journal: JAMA Otolaryngol Head Neck Surg Date: 2022-06-01 Impact factor: 8.961
Authors: Lori Schirle; Amanda L Stone; Matthew C Morris; Sarah S Osmundson; Philip D Walker; Mary S Dietrich; Stephen Bruehl Journal: Syst Rev Date: 2020-06-11