Evaluating contemporary pain management practices in thyroid and parathyroid surgery: A national survey of head and neck endocrine surgeons

Head Neck. 2019 Jul;41(7):2315-2323. doi: 10.1002/hed.25694. Epub 2019 Feb 13.

Abstract

Background: There is currently a lack of evidence-based guidelines regarding postoperative opioids after thyroid and parathyroid surgery. This study aimed to objectively characterize contemporary postoperative pain management practices via a national survey of head and neck endocrine surgeons.

Methods: A standardized electronic survey was distributed to the membership of the American Head and Neck Society's Endocrine section.

Results: A total of 102 surgeons completed the survey representing a 34% response rate. In all, 65.7% of respondents utilize opioids with wide variations in the total morphine equivalents prescribed. Practice environment (χ2 = 10.0; P = 0.04) and performing preoperative pain counseling (χ2 = 9.7; P = 0.002) were significantly associated with a decreased likelihood of prescribing postoperative opioids. Utilization of non-opioid pain management strategies was common and significantly associated with performing outpatient surgery (χ2 = 6.2; P = 0.013) and preoperative pain counseling (χ2 = 4.5; P = 0.034).

Conclusions: Pain management practice patterns vary significantly among head and neck endocrine surgeons which further emphasize the need for evidence-based guidelines.

Keywords: head and neck endocrine surgery; opioid prescribing; parathyroid surgery; postoperative pain; thyroid surgery.

MeSH terms

  • Ambulatory Surgical Procedures / statistics & numerical data
  • Analgesics, Opioid / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Counseling / statistics & numerical data
  • Drug Prescriptions / statistics & numerical data*
  • Hospitalists / statistics & numerical data
  • Humans
  • Pain, Postoperative / drug therapy*
  • Parathyroidectomy*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Surgeons*
  • Surveys and Questionnaires
  • Thyroidectomy*
  • United States

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal