Pain and Opioid Consumption Following Endoscopic Sinus Surgery: A Prospective Cohort Study.
Laryngoscope
; 132(11): 2096-2102, 2022 11.
Article
em En
| MEDLINE
| ID: mdl-34843110
ABSTRACT
OBJECTIVES/HYPOTHESIS:
Surgeons have a critical role in the current opioid epidemic, and there is a need to prospectively understand patterns of pain and opioid use among patients undergoing endoscopic sinus surgery (ESS). STUDYDESIGN:
Prospective observational cohort.METHODS:
This was a prospective, observational cohort study that included patients undergoing ESS from November 2019 to March 2020. Demographic data were collected at baseline, as was respondent information regarding preoperative anxiety, pain, and postoperative pain expectations. Opioid use was converted to milligram morphine equivalents (MME). All patients received 10 tablets of 5 mg oxycodone (75 MME). Patients quantified postoperative pain and opioid consumption via telephone follow-up every 48 hours. The primary outcome was total MME utilized.RESULTS:
There were 91 patients included in the final cohort. Mean opioid use was 35.2 ± 47.3 MME. There were 29 (32%) patients who did not use any opioids after surgery, and six (7%) patients who required opioid refills. Postoperative opioid use was associated with increased preoperative anxiety (r = 0.41, P < .001), preoperative pain (r = 0.28, P = .007), and expectations for postoperative pain (r = 0.36, P < .001). Increased postoperative pain was only associated with increased opioid use on postoperative days 0-2 (r = 0.33, P = .001) and 3-4 (r = 0.59, P < .001). On multivariate regression, former smoking (ß = 23.4 MME, SE = 10.1, 95% confidence interval [CI] 3.3-43.5, P = .023) and anxiety (ß = 35.9, SE = 10.2, 95% CI 15.6-56.3, P < .001) were associated with increased MME.CONCLUSIONS:
The majority of patients have minimal opioid use after ESS, and pain appears to influence opioid use within the first 4 days after surgery. Additionally, patients with anxiety may benefit from alternative pain management strategies to mitigate opioid consumption. LEVEL OF EVIDENCE 3 Laryngoscope, 1322096-2102, 2022.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Analgésicos Opioides
/
Transtornos Relacionados ao Uso de Opioides
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Laryngoscope
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos