Assessment of narcotic use in management of post-op pain after functional endoscopic sinus surgery.

Authors

• Kurren S Gill
• Chandala Chitguppi
• Michelle Haggerty
• Tawfiq Khoury
• Judd Fastenberg
• Gurston Nyquist
• Elina Toskala
• Marc Rosen
• Mindy Rabinowitz

Publication/Presentation Date

2-1-2021

Abstract

OBJECTIVES: Pain and analgesic requirements after functional endoscopic sinus surgery (FESS) vary widely. This study aims to quantify pain after routine FESS and determine the most commonly used pain management regimen.

METHODS: Retrospective chart review of 100 patients who underwent FESS from Oct 2017 to May 2019. Patients prospectively completed a daily pain diary and reported pain levels that were categorized into no pain (0), mild (1-3), moderate (4-7), or severe (8-10). Patients were categorized into narcotics, non-narcotics, combination, or none based on type of analgesic used.

RESULTS: Sixty-nine patients were included. Majority of patients reported either mild (39%) or no pain (28%) during the first 5 PODs. Mean POD1 pain score was 3.98, which decreased with each subsequent POD. On POD1, 37% used opioids (n = 37), 32% used non-opioids (n = 32), 22% used a combination (n = 22), and 9% used no pain meds (n = 9). Mean number of narcotic pills used within the first 5 PODs was 2 pills on any given day. Age was inversely associated with reported POD1 pain scores (

CONCLUSIONS: Even on POD1, majority of patients experienced either mild or no pain, and this decreases with each POD. Narcotics are grossly overprescribed and underutilized by patients postoperatively after FESS. We advocate for more judicious prescribing habits of narcotics by Otolaryngologists after FESS, and emphasize relying on non-narcotic alternatives like Acetaminophen or NSAIDS to diminish narcotic use and abuse in the postoperative period.

LEVEL OF EVIDENCE: 4.

Volume

6

Issue

1

First Page

42

Last Page

48

ISSN

2378-8038

Published In/Presented At

Gill, K. S., Chitguppi, C., Haggerty, M., Khoury, T., Fastenberg, J., Nyquist, G., Toskala, E., Rosen, M., & Rabinowitz, M. (2021). Assessment of narcotic use in management of post-op pain after functional endoscopic sinus surgery. Laryngoscope investigative otolaryngology, 6(1), 42–48. https://doi.org/10.1002/lio2.519

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

33614928

Department(s)

Administration and Leadership

Document Type

Article