Jay K Ferrell1, Michael C Singer2, D Gregory Farwell3, Brendan C Stack4, Maisie Shindo5. 1. Department of Otolaryngology - Head and Neck Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, Texas. 2. Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan. 3. Department of Otolaryngology - Head and Neck Surgery, University of California-Davis, Sacramento, California. 4. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas. 5. Department of Otolaryngology - Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon.
Abstract
BACKGROUND: There is currently a lack of evidence-based guidelines regarding postoperative opioids after thyroid and parathyroid surgery. This study aimed to objectively characterize contemporary postoperative pain management practices via a national survey of head and neck endocrine surgeons. METHODS: A standardized electronic survey was distributed to the membership of the American Head and Neck Society's Endocrine section. RESULTS: A total of 102 surgeons completed the survey representing a 34% response rate. In all, 65.7% of respondents utilize opioids with wide variations in the total morphine equivalents prescribed. Practice environment (χ2 = 10.0; P = 0.04) and performing preoperative pain counseling (χ2 = 9.7; P = 0.002) were significantly associated with a decreased likelihood of prescribing postoperative opioids. Utilization of non-opioid pain management strategies was common and significantly associated with performing outpatient surgery (χ2 = 6.2; P = 0.013) and preoperative pain counseling (χ2 = 4.5; P = 0.034). CONCLUSIONS: Pain management practice patterns vary significantly among head and neck endocrine surgeons which further emphasize the need for evidence-based guidelines.
BACKGROUND: There is currently a lack of evidence-based guidelines regarding postoperative opioids after thyroid and parathyroid surgery. This study aimed to objectively characterize contemporary postoperative pain management practices via a national survey of head and neck endocrine surgeons. METHODS: A standardized electronic survey was distributed to the membership of the American Head and Neck Society's Endocrine section. RESULTS: A total of 102 surgeons completed the survey representing a 34% response rate. In all, 65.7% of respondents utilize opioids with wide variations in the total morphine equivalents prescribed. Practice environment (χ2 = 10.0; P = 0.04) and performing preoperative pain counseling (χ2 = 9.7; P = 0.002) were significantly associated with a decreased likelihood of prescribing postoperative opioids. Utilization of non-opioid pain management strategies was common and significantly associated with performing outpatient surgery (χ2 = 6.2; P = 0.013) and preoperative pain counseling (χ2 = 4.5; P = 0.034). CONCLUSIONS:Pain management practice patterns vary significantly among head and neck endocrine surgeons which further emphasize the need for evidence-based guidelines.
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