Opioid Prescriptions Following Otologic Surgery: A Population-Based Study
| Autor: | Gregory Klar, Paul Nguyen, Keshinisuthan Kirubalingam, Jason A. Beyea, Joanna M. Dion, Robert J. Campbell |
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| Rok vydání: | 2021 |
| Předmět: |
Ontario
medicine.medical_specialty education.field_of_study Pain Postoperative Perioperative medicine business.industry Otologic surgery Population Pain management Drug Prescriptions Population based study Analgesics Opioid Otorhinolaryngology Opioid Emergency medicine Medicine Humans Surgery Medical prescription Practice Patterns Physicians' business education Otologic Surgical Procedures medicine.drug Retrospective Studies |
| Zdroj: | Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. 167(1) |
| ISSN: | 1097-6817 |
| Popis: | To examine postoperative opioid-prescribing patterns following otologic surgery.Retrospective population-based descriptive study.All hospitals in the Canadian province of Ontario.Of all patients with advanced ear surgery between July 1, 2012, and March 31, 2019, 7 cohorts were constructed: tympanoplasty with or without ossiculoplasty (n = 7812), atticotomy/limited mastoidectomy (n = 1371), mastoidectomy (n = 3717), semicircular canal occlusion (SCO; n = 179), stapedectomy (n = 2735), bone-implanted hearing aid insertion (n = 280), and cochlear implant (n = 2169). Prescriptions filled for narcotics postoperatively were calculated per morphine milligram equivalent (MME) opioid dose. Multivariable regression was used to determine predictors of higher opioid doses.The mean ± SD MMEs prescribed were as follows: tympanoplasty with or without ossiculoplasty, 246.77 ± 1380.78; atticotomy/limited mastoidectomy, 283.32 ± 956.10; mastoidectomy, 280.56 ± 1018.50; SCO, 328.61 ± 1090.86; stapedectomy, 164.64 ± 657.18; bone-implanted hearing aid insertion, 326.11 ± 1054.66; and cochlear implant, 200.87 ± 639.93. SCO (odds ratio [OR], 1.69 [95% CI, 1.16-2.48]) and mastoidectomy (OR, 1.50 [95% CI, 1.36-1.66]) were associated with higher opioid doses than tympanoplasty-ossiculoplasty. Asthma (OR, 1.24 [95% CI, 1.12-1.38]), chronic obstructive pulmonary disease (OR, 1.29 [95% CI, 1.12-1.47]), myocardial infarction (OR, 1.33 [95% CI, 1.05-1.68]), diabetes (OR, 1.22 [95% CI, 1.08-1.39]), and substance-related and addictive disorders (OR, 2.59 [95% CI, 1.67-4.00]) were associated with higher opioid doses prescribed. Overall MME prescribed by year demonstrates a sharp drop from 2017-2018 to 2018-2019.This large comprehensive population study provides insight into the prescribing patterns following otologic surgery. The large amounts prescribed and substantial variation require further study to determine barriers that limit good opioid-prescribing stewardship in the postoperative period. |
| Databáze: | OpenAIRE |
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