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Head Neck. 2019 Feb 13. doi: 10.1002/hed.25694. [Epub ahead of print]

Evaluating contemporary pain management practices in thyroid and parathyroid surgery: A national survey of head and neck endocrine surgeons.

Author information

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.

KEYWORDS:

head and neck endocrine surgery; opioid prescribing; parathyroid surgery; postoperative pain; thyroid surgery

PMID:
30758893
DOI:
10.1002/hed.25694

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