Background: Postoperative opiate-based analgesia prescriptions in ENT as in other specialities remain a continuous challenge to surgeons. The use of opioids for adequate analgesia in procedures recognised to have severe pain post-surgery is tempered by their associated complications of addiction risk, tolerance, and opioid related mortalities. The current acknowledged opioid epidemic in the USA and the reported opioid related mortality of between 90 to 100 a day must be taken as a universal wake-up call. This includes greater awareness and vigilance in our own patient management as it is estimated that approximately 50% of the opioids are sourced from medical prescriptions. This opioid prescription review aims at providing a literature update and recommendations for our speciality including what we should be doing to alleviate pain in our postoperative patients while avoiding catastrophic consequences.
Methods: Literature review using keywords: opioid analgesic, opioid overdose, opioids in ENT, opioid Mortality, complications, opioid naïve, abuser, tolerance.
Results: Multiple papers review involving postoperative opioid management in Both ENT and other surgical discipline
Conclusions: A multi-disciplinary approach is essential with regular and timely review of prescriptions, protocols, outcomes and targeted pre-operative assessment including the categorising of patients into opioid naïve, opiate abuser, chronic opioid user, and opioid tolerance groups.
