Postoperative Pain and Opioid Use After Thyroid and Parathyroid Surgery-A Pilot, Prospective SMS-Based Survey

J Surg Res. 2019 Aug;240:236-240. doi: 10.1016/j.jss.2019.03.016. Epub 2019 Apr 17.

Abstract

Background: New persistent opioid use has been identified following minor surgical procedures and may contribute to the national opioid epidemic. Prescription patterns vary and we have limited data on patient pain experiences in the outpatient setting. We devised a novel short messaging service survey to record pain scores and opioid use following outpatient thyroid or parathyroid surgery.

Materials and methods: Automated short messaging service was sent daily starting the evening of the operation until postoperative day (POD) 10. Pain was assessed on a 0-10 numeric pain rating scale and opioid use over the prior 24 h was queried.

Results: A total of 1264 survey questions were sent with overall response rate of 84.3%. Fifty-three of 58 patients had a response rate >50% and were included in the final analysis. Average pain score was highest on POD1 at 3.2. Overall, 42.5% of patients utilized opioids on POD0, 55.6% on POD1, and steadily decreased to 7% by POD10. Overall, 34% of patients did not utilize any opioids postoperatively. Scaled total pain scores were higher in patients with thyroid surgery (23.5 versus 12.1, P = 0.02) and lower in those who reported alcohol use (14.9 versus 31.6, P < 0.02). Scaled total opioid days were lower in those aged >60 (1.5 versus 3.6, P < 0.01) and higher in those with active tobacco use (4.5 versus 2.3, P = 0.04). Pain scores correlated weakly with total opioid days (r = 0.32).

Conclusions: We demonstrate a novel approach of obtaining patient reported daily, prospective pain scores. This may help us understand patient pain and opioid use in the acute postoperative period especially following outpatient surgery.

Keywords: Opioid use; Parathyroidectomy; Postoperative pain; SMS; Survey; Thyroidectomy.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ambulatory Surgical Procedures / adverse effects
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Drug Utilization / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Opioid Epidemic / prevention & control
  • Pain Measurement / methods
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy*
  • Pain, Postoperative / etiology
  • Parathyroidectomy / adverse effects*
  • Pilot Projects
  • Postoperative Care / methods*
  • Prospective Studies
  • Surveys and Questionnaires
  • Text Messaging
  • Thyroidectomy / adverse effects*
  • Young Adult

Substances

  • Analgesics, Opioid