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Opioid reduction in ambulatory thyroid and parathyroid surgery after implementing enhanced recovery after surgery protocol
Author(s) -
Lide Riley C.,
Creighton Erin Weatherford,
Yeh Jessica,
Troughton Mikayla,
Hollowoa Blake,
Merrill Tyler,
Robbins Alexa,
Orman Gray,
Breckling Meghan,
Vural Emre,
Moreno Mauricio,
Stack Brendan C.
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26617
Subject(s) - medicine , ambulatory , anesthesia , opioid , premedication , thyroid , surgery , receptor
Background Opioid abuse is widespread in the United States and the risk for chronic use is increased in surgical patients, including patients with thyroid and parathyroid. Methods Records for 171 patients prior to and 67 patients following implementation of an enhanced recovery after surgery (ERAS) protocol for ambulatory thyroid/parathyroid surgeries were reviewed. The ERAS included superficial cervical plexus block, multimodal premedication, and postoperative reliance on acetaminophen and ibuprofen with judicious prescribing of opioids. Results Post‐ERAS patients were prescribed a mean 72 morphine milligram equivalents (MME); pre‐ERAS patients were prescribed a mean 163 MME ( p < 0.001). 97.1% of pre‐ERAS patients were prescribed opioids with 91.1% filled; 68.7% of post‐ERAS study patients were prescribed opioids with 84.8% filled. Conclusion Implementation of ERAS and focus on prescribing practices decreased the MME prescribed and used for ambulatory thyroid and parathyroid surgery. Future steps include increased patient education and tracking pain scores and medication utilization out of hospital.