Is otologic surgery contributing to the opioid epidemic?

Abstract Background The opioid epidemic is a significant public health crisis challenging the lives of North Americans. Interestingly, this problem does not exist to the same extent in Europe. Surgeons play a significant role in prescribing opioids, especially in the context of post-operative pain m...

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Main Authors: Valerie Dahm, Justin T. Lui, Rudolfs Liepins, Joseph M. Chen, Trung N. Le, Christoph Arnoldner, Vincent Y. W. Lin
Format: Article
Language:English
Published: SAGE Publishing 2021-06-01
Series:Journal of Otolaryngology - Head and Neck Surgery
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Online Access:https://doi.org/10.1186/s40463-021-00521-1
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author Valerie Dahm
Justin T. Lui
Rudolfs Liepins
Joseph M. Chen
Trung N. Le
Christoph Arnoldner
Vincent Y. W. Lin
author_facet Valerie Dahm
Justin T. Lui
Rudolfs Liepins
Joseph M. Chen
Trung N. Le
Christoph Arnoldner
Vincent Y. W. Lin
author_sort Valerie Dahm
collection DOAJ
description Abstract Background The opioid epidemic is a significant public health crisis challenging the lives of North Americans. Interestingly, this problem does not exist to the same extent in Europe. Surgeons play a significant role in prescribing opioids, especially in the context of post-operative pain management. The aim of this study was to compare the post-surgical prescribing patterns of otologists comparing Canada and Austria. Methods An online questionnaire was sent to 33 Canadian and 32 Austrian surgeons, who perform otologic surgery on a regular basis. Surgeons were asked to answer some questions about their background as well as typical prescribing patterns for postoperative pain medication for different ear surgeries (cochlear implant, stapedotomy, tympanoplasty). In addition, surgeons were asked about the typical use of local anesthetics for pain control at the end of a procedure. Otologists gave an estimate how confident they were that their therapy and prescriptions provide sufficient pain control to their patients. Results Analysis of the returned questionnaires showed that opioids are more commonly prescribed in Canada than in Austria. Nonsteroidal anti-inflammatory drugs are used for postoperative pain more regularly after ear surgery in Austria, as opposed to Canada. Some of the prescribed drugs by European otologists are not available in North America. The use of local anesthetics at the end of surgery is not common in Austria. Surgeons´ confidence that the prescribed pain medication was sufficient to control postoperative symptoms was higher in the group not prescribing opioids than in the group that did routinely prescribe opioids. Conclusion Prescribing patterns differ substantially between the two evaluated countries. This data suggests an opportunity to reduce opioid prescriptions after otologic surgeries. Studies to evaluate pain after these operations as well as efficacy of analgesics following ear surgery are an important next step. Graphical abstract
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spelling doaj-art-978d87bc97de471791f996bc186d4f0d2025-02-03T10:54:10ZengSAGE PublishingJournal of Otolaryngology - Head and Neck Surgery1916-02162021-06-015011810.1186/s40463-021-00521-1Is otologic surgery contributing to the opioid epidemic?Valerie Dahm0Justin T. Lui1Rudolfs Liepins2Joseph M. Chen3Trung N. Le4Christoph Arnoldner5Vincent Y. W. Lin6Department of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of TorontoDepartment of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of TorontoDepartment of Otorhinolaryngology, Head & Neck Surgery, Medical University of ViennaDepartment of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of TorontoDepartment of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of TorontoDepartment of Otorhinolaryngology, Head & Neck Surgery, Medical University of ViennaDepartment of Otolaryngology–Head & Neck Surgery, Sunnybrook Health Sciences Centre, University of TorontoAbstract Background The opioid epidemic is a significant public health crisis challenging the lives of North Americans. Interestingly, this problem does not exist to the same extent in Europe. Surgeons play a significant role in prescribing opioids, especially in the context of post-operative pain management. The aim of this study was to compare the post-surgical prescribing patterns of otologists comparing Canada and Austria. Methods An online questionnaire was sent to 33 Canadian and 32 Austrian surgeons, who perform otologic surgery on a regular basis. Surgeons were asked to answer some questions about their background as well as typical prescribing patterns for postoperative pain medication for different ear surgeries (cochlear implant, stapedotomy, tympanoplasty). In addition, surgeons were asked about the typical use of local anesthetics for pain control at the end of a procedure. Otologists gave an estimate how confident they were that their therapy and prescriptions provide sufficient pain control to their patients. Results Analysis of the returned questionnaires showed that opioids are more commonly prescribed in Canada than in Austria. Nonsteroidal anti-inflammatory drugs are used for postoperative pain more regularly after ear surgery in Austria, as opposed to Canada. Some of the prescribed drugs by European otologists are not available in North America. The use of local anesthetics at the end of surgery is not common in Austria. Surgeons´ confidence that the prescribed pain medication was sufficient to control postoperative symptoms was higher in the group not prescribing opioids than in the group that did routinely prescribe opioids. Conclusion Prescribing patterns differ substantially between the two evaluated countries. This data suggests an opportunity to reduce opioid prescriptions after otologic surgeries. Studies to evaluate pain after these operations as well as efficacy of analgesics following ear surgery are an important next step. Graphical abstracthttps://doi.org/10.1186/s40463-021-00521-1Otologic surgeryPainOpioidsPrescriptionMedication
spellingShingle Valerie Dahm
Justin T. Lui
Rudolfs Liepins
Joseph M. Chen
Trung N. Le
Christoph Arnoldner
Vincent Y. W. Lin
Is otologic surgery contributing to the opioid epidemic?
Journal of Otolaryngology - Head and Neck Surgery
Otologic surgery
Pain
Opioids
Prescription
Medication
title Is otologic surgery contributing to the opioid epidemic?
title_full Is otologic surgery contributing to the opioid epidemic?
title_fullStr Is otologic surgery contributing to the opioid epidemic?
title_full_unstemmed Is otologic surgery contributing to the opioid epidemic?
title_short Is otologic surgery contributing to the opioid epidemic?
title_sort is otologic surgery contributing to the opioid epidemic
topic Otologic surgery
Pain
Opioids
Prescription
Medication
url https://doi.org/10.1186/s40463-021-00521-1
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