Author(s)
Robert E. Africa, MD
Amber M. Dunmire, MD
Brian J. McKinnon, MD
Harold S. Pine, MD
Yusif Hajiyev, MD
Charles A. Hughes, MD
Affiliation(s)
University of Texas Medical Branch;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to understand the trends of opioids prescription for adenotonsillectomy at a national level from a large national database before and after the publication of the American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines on Opioid Prescribing for Analgesia and compare to their own surgical practice.
Objectives: To evaluate the trends in opioid and nonopioid prescribing for pediatric adenotonsillectomy before and after the publication of guidelines by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in April 2021.
Study Design: Retrospective study with de-identified data.
Methods: The TriNetX national database collect summary data of pediatric patients age greater than 12 who were prescribed opioid analgesics after adenotonsillectomy from January 1, 2018, to December 31, 2023, from the electronic medical records of 86 healthcare organizations. The trends in opioid prescription were statistically evaluated by interrupted time series analysis in Statistical Analysis System (SAS) 9.4 with significance set at p < 0.05 to assess trends before and after the new opioid prescription guidelines.
Results: The rate of postoperative opioid prescriptions significantly decreased following the publication of the new clinical practice guidelines, dropping from 0.27 cases per year before the guideline changes to -0.38 cases per year afterward (p = 0.03). This reduction was immediate and sustained through December 31, 2023.
Conclusions: After the recommendations regarding opioid prescription were published by the AAO-HNS, surgeons appeared to be cognizant of prescribing trends. The rate of nonopioid prescription alone remained stable.