Despite emerging evidence that supports the use of alternative analgesic pain management strategies, some head and neck or endocrine surgeons continue to prescribe opioids after thyroid procedures, according to study results published in International Journal of General Medicine.
An investigator from King Khalid University in Abha, Saudi Arabia conducted a retrospective cohort study to assess recent opioid distribution practices. All patients (N=105) who were opioid-naïve and underwent thyroid procedures between January 1, 2019 and September 31, 2021 in southwestern Saudi Arabia were evaluated for medications prescribed at discharge.
Patients were a mean age of 43.3±10.2 years, 90.5% were women, 49.5% underwent thyroid lobectomy, 41.9% total thyroidectomy, and 8.6% subtotal thyroidectomy.
At discharge, most patients received opioids (59.0%), specifically codeine combined with paracetamol.
Stratified by surgical procedure, the rate of opioid distribution was highest for lobectomy (63.5%), followed by subtotal thyroidectomy (55.6%) and total thyroidectomy (54.5%). The remaining patients were given paracetamol without codeine at discharge. The difference in prescribing practices did not differ significantly on the basis of surgical procedure (c2=0.833; P =.659). However, opioid prescribing was found to differ on the basis of age group (c2=5.842; P =.013). Opioids were more often given to patients under 40 years (71.4%) compared with patients 40 years and older (48.2%).
Limitations of this study included its small sample size, the exclusion of opioid dosage in the analysis, as well as the geographic location of the study.
“This study revealed that some head and neck endocrine surgeons continuously prescribe certain opioids despite emerging evidence that supports the use of non-opioid and alternative analgesic strategies in outpatient thyroid surgery, the study author concluded. “Further research and quality improvement interventions should be geared toward leading all health professionals to appropriate prescribing practices to improve patient safety and reduce unnecessary opioid prescriptions,” the author added.
Alzahrani HA. Patterns of prescribing postoperative analgesic medication after thyroid surgery: a retrospective cohort study. Int J Gen Med. 2023;16:405-410. doi:10.2147/IJGM.S401828