Opioid Prescribing for Analgesia After Common Otolaryngology Operations

Publication Date: April 6, 2021

Key Action Statements 

1. Expected Pain

Prior to surgery, clinicians should advise patients and others involved in the postoperative care about the expected duration and severity of pain. (Recommendation (R), )
571

2. Modifying Factors

Prior to surgery, clinicians should gather information specific to the patient that modifies severity and/or duration of pain. (Recommendation (R), )
571

3A. Risk Factors for Opioid Use Disorder 

Prior to surgery, clinicians should identify risk factors for Opioid Use Disorder (OUD) when analgesia using opioids is anticipated. (Strong Recommendation (S), )
571

3B. Patients at Risk for OUD

In patients at risk for OUD, clinicians should evaluate the need to modify the analgesia plan. (Recommendation (R), )
571

4. Shared Decision Making

Clinicians should promote shared decision making by informing patients of the benefits and risks of postoperative pain treatments that include nonopioid analgesics, opioid analgesics, and nonpharmacologic interventions. (Recommendation (R), )
571

5. Multimodal Therapy

Clinicians should develop a multimodal treatment plan for managing postoperative pain. (Recommendation (R), )
571

6. Nonopioid Analgesia

Clinicians should advocate for nonopioid medications as first-line management of pain after otolaryngologic surgery. (Strong Recommendation (S), )
571

7. Opioid Prescribing

When treating postoperative pain with opioids, clinicians should limit therapy to the lowest effective dose and the shortest duration. (Recommendation (R), )
571

8A. Patient Feedback

Clinicians should instruct patients and caregivers how to communicate if pain is not controlled or if medication side effects occur. (Recommendation (R), )
571

8B. Stopping Pain Medications

Clinicians should educate patients to stop opioids when pain is controlled with nonopioids and stop all analgesics when pain has resolved. (Recommendation (R), )
571

9. Storage and Disposal of Opioids

Clinicians should recommend that patients (or their caregivers) store prescribed opioids securely and dispose of unused opioids through take-back programs or another accepted method. (Strong Recommendation (S), )
571

10. Assessment of Pain Control with Opioids

Clinicians should inquire, within 30 days of surgery, whether the patient has stopped using opioids, has disposed of unused opioids, and was satisfied with the pain management plan. (Recommendation (R), )
571

Recommendation Grading

Disclaimer

Overview

Title

Opioid Prescribing for Analgesia After Common Otolaryngology Operations

Authoring Organization

Publication Month/Year

April 6, 2021

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Male, Female, Adolescent, Adult

Health Care Settings

Ambulatory, Emergency care, Hospital

Intended Users

Addiction treatment specialist, nurse, nurse practitioner, physician, physician assistant

Scope

Assessment and screening, Management

Keywords

analgesia, Pain Management, Clinical Practice Guideline, Prescribing of Opioids, otolaryngology surgery

Methodology

Number of Source Documents
230
Literature Search Start Date
January 1, 2009
Literature Search End Date
October 19, 2019