Opioid Prescribing Patterns After Skull Base Surgery for Vestibular Schwannoma.
Otol Neurotol
; 43(1): e116-e121, 2022 01 01.
Article
en En
| MEDLINE
| ID: mdl-34889846
ABSTRACT
OBJECTIVE:
Excessive opioid prescription is a source of prescription diversion and could contribute to chronic opioid abuse. This study describes the opioid prescribing patterns and risk factors for additional opioid prescription after surgical resection of vestibular schwannoma (VS). STUDYDESIGN:
Retrospective chart review.SETTING:
Single tertiary referral center. PATIENTS Adult VS patients undergoing surgical resection between May 2019 and March 2020.INTERVENTIONS:
Opioid use postoperatively and up to 60âdays following surgery were characterized from medical records and by querying the state-wide Controlled Substance Utilization Review and Evaluation System. MAIN OUTCOMEMEASURES:
The presence of additional opioid prescriptions within 60âdays of surgery.RESULTS:
A total of 109 patients (mean age 50âyrs, 65.5% female) were prescribed an average of 138.2â±â117.8âmg of morphine equivalents (MME). Twenty-two (20.9%) required additional prescriptions of 163.2â±â103.2 MME. Age, gender, tumor size, or surgical approach (translabyrinthine, retrosigmoid, versus middle fossa) were not associated with additional prescriptions. Patients with additional prescriptions had higher body mass index (BMI 28.8 vs. 25.8âkg/m2, pâ=â0.015) and required more opioid medications during hospitalization (51.8 vs. 29.1 MME, pâ=â0.002). On multivariate logistic regression, higher BMI (odds ratio [OR] 1.32; pâ=â0.001), history of headaches (OR 11.9, pâ=â0.011), and history of opioid use (OR 29.3, pâ=â0.008) were associated with additional prescription.CONCLUSIONS:
Additional opioid prescriptions may be necessary in a portion of VS patients undergoing surgery. The choice of surgical approach is not associated with excess opioid requirements. Patients with higher BMI, history of headaches, or preoperative opioid use may require additional prescriptions.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neuroma Acústico
/
Analgésicos Opioides
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Otol Neurotol
Asunto de la revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Año:
2022
Tipo del documento:
Article