Contrasting opioid use for pain management in microvascular head and neck reconstruction: an international study. Issue 11 (November 2022)

• Record Type: Journal Article
• Authors: Weyh, A.M.; Pucci, R.; Busby, E.; Kansal, L.; Joy, R.; Bunnell, A.; Valentini, V.; Dyalram, D.; Pattatheyill, A.; Figari, M.; Boccalatte, L.; Larrañaga, J.; Cassoni, A.; Fernandes, R.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 51:Issue 11(2022)
• Page Start: 1412
• Page End: 1419
• Publication Date: 2022-11
• Subjects: Head and neck cancer -- Opioids -- Pain management -- Free tissue flaps -- Analgesia -- Reconstructive surgical procedures -- Microsurgery; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2022.04.016
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: Opioids are often the mainstay of postoperative pain management, despite strong evidence of their ill effects and potential for long-term addiction. The goal of this study was to quantify opioid use and contrast pain management strategies of multiple international institutions performing fibula free flap reconstruction. A retrospective multicenter cohort study was designed, including five international centers. For inclusion, the patients had to have undergone a primary fibula free flap reconstruction of the mandible. A total of 185 patients were included. The median opioid use across all centers at 72 hours was 133 oral morphine equivalents. The highest utilization was in the USA ( P < 0.001), which was approximately six times that of Italy, four times that of Argentina, and twice that of India, despite all centers performing a similar procedure. Based on this study there are clear differences in prescribing practices and ideologies among surgeons from different countries.