(0233) Opioid Prescribing in Ambulatory Otolaryngology Procedures

Introduction: Overprescription of opioids can have many negative consequences, including chronic opioid use and misuse. Our goal is to characterize opioid prescribing patterns after ambulatory otolaryngology procedures.

Methods: A retrospective chart review was performed at a single institution over three years for adult patients undergoing ambulatory otolaryngology surgeries.
Patient demographic variables such as age, sex, ethnicity, medical comorbidities, surgery performed, type and quantity of opioid prescribed was collected.  In addition, opioid prescriber data and follow up data was collected. The amount of opioid prescribed was standardized by converting to morphine milligram equivalent (MME). Surgeries were filtered by current procedural terminology (CPT) code.

Results: A total of 2,129 patients were identified, 52.8% were female with an average age of 46.7 years. The most common surgery type was nasal (38.6%), followed by otologic (22.7%), head and neck (22.6%), oropharyngeal (10.9%), and trauma (2.5%). Significant differences were seen between female and male patients (92.6 MME and 82.9 MME, respectively, p = 0.0035). Significant differences were found in MME among differing racial groups, with Black patients being prescribed the highest, followed by other, White, and Asian, p < 0.001. Higher opioid dosages were prescribed in those with depression (p = 0.0056), other psychological conditions (p = 0.0065), and neuropathy (p = 0.0009). Patients that received at least one refill had significantly greater MME (144.9 MME) than those who were not given refills (83.7 MME, p < 0.001). Significant differences in average MME prescribed were found among different surgery types, with the highest in oropharyngeal surgeries. Lastly, attending surgeons with over 10 years of experience and head and neck surgeons prescribed significantly more opioids.

Conclusions: The average MME prescribed varied significantly by racial group, gender, and type of surgery. In addition, neuropathy, depression, and other psychological conditions are significantly associated with greater average MME prescribed.