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Multifaceted strategy needed to reduce opioid use after rhinoplasty

Findings from a recent study shed light on pain medication use following rhinoplasty, with results indicating patients often fail to take all the combination hydrocodone-acetaminophen tablets prescribed.

The case series included 62 patients who underwent rhinoplasty at two sites in the United States between February and September of 2016. The researchers aimed to investigate prescription patterns for opioids and other pain medications in the postoperative setting and establish a regimen for managing pain in these patients. Outcome measures included opioid use, pain control and adverse events. Factors that underwent investigation included rhinoplasty vs. septoplasty, open vs. closed techniques, primary vs. revision procedures, and use of turbinates and osteotomies. Self-reported use of 5-mg hydrocodone bitartrate and 325-mg acetaminophen also were evaluated.

Patients were initially prescribed 20 to 30 hydrocodone-acetaminophen combination tablets, of which 40% were prescribed following rhinoplasty. Results showed that they used a mean of 8.7 (standard error of the mean, 0.9) of those tablets.

Nearly three-quarters of the cohort (74%) consumed 15 tablets or fewer. Refills were reported in 5% of patients.

No association was reported between the number of tablets used and many factors, including gender, age, concurrent septoplasty or turbinate reduction, use of osteotomy or history of a rhinoplasty.

Drowsiness was the most commonly reported adverse event, at 35%. Eleven percent of patients reported nausea, while light-headedness and constipation were both reported in 5% of the cohort.

“To mitigate the misuse or diversion of physician-prescribed opioid medications, surgeons must be steadfast in prescribing an appropriate amount of pain medication after surgery,” the researchers concluded. “A multifaceted pain control program is proposed to manage postoperative pain and ascertain the balance between controlling pain and avoiding overprescribing narcotics.” – by Rob Volansky

Disclosures: The authors report no relevant financial disclosures.