Opioid Prescribing for Analgesia After Common Otolaryngology Operations

Publication Date: April 5, 2021
Last Updated: March 14, 2022

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), )
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2. Modifying Factors

Prior to surgery, clinicians should gather information specific to the patient that modifies severity and/or duration of pain. (Recommendation (R), )
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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), )
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3B. Patients at Risk for OUD

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

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

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

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

Overview

Title

Opioid Prescribing for Analgesia After Common Otolaryngology Operations

Authoring Organization

American Academy of Otolaryngology - Head and Neck Surgery Foundation

Publication Month/Year

April 5, 2021

Last Updated Month/Year

November 25, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

The purpose of this specialty-specific CPG is to provide clinicians who treat patients with otolaryngologic disorders with evidence-based recommendations on perioperative opioid-based pain management for common otolaryngologic surgical procedures. This guideline also identifies quality improvement opportunities, including patient assessment, side effect and complication prevention, and reduction in unnecessary variation in practice.

Target Patient Population

Any individual who requires treatment for anticipated or reported pain within 30 days after common otolaryngologic procedures

Target Provider Population

Otolaryngologists who perform surgery and clinicians who manage pain after surgical procedures

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

Source Citation

Anne SA, Mims JW, Tunkel DE, et al. Clinical practice guideline: opioid prescribing for analgesia after common otolaryngology operations. Otolaryngol Head Neck Surg. 2021;164(2_suppl):S1-S42.

Methodology

Number of Source Documents
230
Literature Search Start Date
December 31, 2008
Literature Search End Date
October 18, 2019