A Randomized Single‐Blinded Trial of Ibuprofen‐ versus Opioid‐Based Primary Analgesic Therapy in Outpatient Otolaryngology Surgery. (5th March 2019)

• Record Type: Journal Article
• Authors: Nguyen, Khanh K.; Liu, Yuan F.; Chang, Crystal; Park, Jaimie J.; Kim, Cherine H.; Hondorp, Brian; Vuong, Christopher; Xu, Helen; Crawley, Brianna K.; Simental, Alfred A.; Church, Christopher A.; Inman, Jared C.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 160:Number 5(2019)
• Page Start: 839
• Page End: 846
• Publication Date: 2019-03-05
• Subjects: postoperative pain -- outpatient surgery -- thyroidectomy -- parathyroidectomy -- functional endoscopic sinus surgery -- septoplasty -- endolaryngeal procedures -- otologic surgery -- opioid therapy -- ibuprofen; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599819832528
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objective: To compare the efficacy of pain control and opioid consumption between patients who receive opioid as primary analgesic therapy and those who receive ibuprofen. Study Design: Prospective randomized trial. Setting: Tertiary care academic hospital. Subject and Methods: Adult patients undergoing outpatient otolaryngology surgery were assigned to take hydrocodone/acetaminophen or ibuprofen for postoperative analgesia. Patient‐recorded pain scores and analgesic consumption were analyzed. Results: Out of 185 recruits, 108 (58%) completed responses. Fifty‐six patients (52%) received opioid medication for primary analgesic treatment versus 52 (48%) who received ibuprofen. There was no difference in reported pain scores between the treatment groups. Those who received ibuprofen as primary therapy reported a significantly lower consumption of opioid medication at 2.04 tablets/pills (95% CI, 0.9‐3.1) versus 4.86 (3.6‐6.1; P =. 001). Based on multivariate analysis, male sex and older age exhibited lower reported pain scores, while older age and use of ibuprofen as primary therapy exhibited lower opioid requirements. Conclusion: For postoperative pain management in outpatient otolaryngology procedures, ibuprofen as primary therapy can provide equally effective pain control as compared with hydrocodone/acetaminophen while decreasing overall opioid requirement. Prescription pill counts are further described to help guide physician practices in the era of an opioid epidemic.