Author(s)
Amir A. Mohammadzadeh, BS
Omid Moshtaghi, MD, MS
Pasha Mehranpour
Alice I. Chen, DO
Jamie N. LaBuzetta, MD
Marc S. Schwartz, MD
Rick A. Friedman, MD PhD
Affiliation(s)
University of California San Diego School of Medicine;
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to discuss the potential benefits of osteopathic manipulative treatment in reducing postoperative opioid use and hospital length of stay after acoustic neuroma surgery. Objectives: To determine the impact that supplemental osteopathic manipulative treatment (OMT) has on postoperative opioid use and hospital length of stay (LOS) in patients undergoing acoustic neuroma (AN) resection. Study Design: Retrospective cohort study of patients undergoing AN resection at a single tertiary referral center. Ten patients from November 2018 who did not receive OMT were compared to ten patients from May to June 2019 who did receive OMT. OMT was given on postoperative day one for patients enrolled. Methods: The main outcome measures were opioid consumption in morphine milligram equivalents (MME), acetaminophen (APAP) consumption in milligrams, and LOS in days. Total opioid and APAP consumption were measured beginning on postoperative day one and averaged over LOS. Results: Preliminary data demonstrated that patients receiving OMT took an average of almost two times less MME per day than non-OMT patients (64.7 mg and 111.2 mg respectively, p=0.14). LOS was also 0.7 days shorter in patients receiving OMT (p=0.33). Average daily APAP consumption remained comparable between the OMT and non-OMT cohorts (1895.4 mg and 1987.3 mg respectively, p=0.74). Conclusions: In the setting of rising national opioid use and healthcare costs, OMT can be a useful adjunct in reducing pain and LOS in postoperative AN patients. Future analyses with greater enrollment will increase the power and sensitivity needed to further delineate the utility of OMT.