Current Opioid Prescribing Patterns after Microdirect Laryngoscopy

Abstract

Background: The prevalence of opioid abuse has become epidemic in the United States. Microdirect laryngoscopy (MDL) is a common otolaryngological procedure, yet prescribing practices for opioids following this operation are not well characterized. Objective: To characterize current opioid-prescribing patterns among otolaryngologists performing MDL. Methods: A cross-sectional survey of otolaryngologists at a national laryngology meeting. Results: Fifty-eight of 205 physician registrants (response rate 28%) completed the survey. Fifty-nine percent of respondents were fellowship-trained in laryngology. Respondents performed an average of 13.3 MDLs per month. Thirty-four percent of surgeons prescribe opioids for over two-thirds of their MDLs, while only 7% of surgeons never prescribe opioids. Eighty-eight percent of surgeons prescribed a combination opioid and acetaminophen compound, hydrocodone being the most common opioid component. Many surgeons prescribe non-opioid analgesics as well, with 70% and 84% of surgeons recommending acetaminophen and ibuprofen after MDL respectively. When opioids were prescribed, patient preference, difficult exposure and history of opioid use were the most influential patient factors. Concerns of opioid abuse, the physician role in the opioid crisis, and literature about postoperative non-opioid analgesia were also underlying themes in influencing opioid prescription patterns after MDL. Conclusions: In this study, over 90% of practicing physicians surveyed are prescribing opioids after MDL, though many are also prescribing non-opioid analgesia as well. Further studies should be completed to investigate the needs of patients following MDL in order to allow physicians to selectively and appropriately prescribe opioid analgesia postoperatively.

Patient Perception and Duration of Pain after Microdirect Laryngoscopy

“…One of the interesting results of our study is that only about one‐fourth of patients required the opioid usage. We agree with Huston et al 21 and Taliercio et al 20 that opioids may be overprescribed for routine MDL. Anti‐inflammatory and over‐the‐counter analgesics can be used as an alternative to ameliorate the pain after MDL.…”

“…In a recent survey of otolaryngologists at an American laryngology meeting, over 90% of otolaryngologists prescribed opioids to patients after MDL. 21 This trend is similar to our senior author's practice of prescribing a small amount of Tylenol #3 to postoperative MDL patients. One of the interesting results of our study is that only about one-fourth of patients required the opioid usage.…”

“…Judicious prescribing of opioids is an important topic with the current opioid crisis. In a recent survey of otolaryngologists at an American laryngology meeting, over 90% of otolaryngologists prescribed opioids to patients after MDL 21 . This trend is similar to our senior author’s practice of prescribing a small amount of Tylenol #3 to postoperative MDL patients.…”

Long-term impact of olfactory dysfunction on daily life

“…One of the flaws of this study is the relatively poor overall response rate of 20%, which has been also an issue in previous studies and might have been arisen due to the long follow-up time [ 51 , 52 ]. The following reasons could have also been responsible for the poor follow-up rate: firstly, OD improved and there was no further need for treatment.…”

“…Long-term impact of olfactory dysfunction on daily life K original article due to the long follow-up time [51,52]. The following reasons could have also been responsible for the poor follow-up rate: firstly, OD improved and there was no further need for treatment.…”