Usage patterns of postoperative pain control medication after thyroidectomy: A retrospective cohort study

Background Thyroid surgery is one of the most common surgical procedures with typical mild-to-moderate pain postoperatively. Thus, postoperative pain control is clearly of primary concern to patients, as well as surgeons. The unnecessary use of opioid analgesics is a well-known contributing factor to opioid addiction. Recently, experts from the Endocrine Surgery Section of the American Head and Neck Society released a consensus to limit the use of opioid medications as the first-line pain medications after head and neck or endocrine procedures. Thus, this study aimed to evaluate the postoperative pain control medication prescription practices of head and neck or endocrine surgeons for patients who underwent thyroid surgery. Methods This study retrospectively reviewed the charts of 105 adult patients who underwent thyroid surgery (total thyroidectomy, thyroid lobectomy, or subtotal thyroidectomy) by head and neck or endocrine surgeons. The type of prescribed pain medication at hospital discharge postoperatively was then retrieved from each patient’s discharge medication list. Descriptive statistics mean, standard deviations, frequencies, and percentages were computed, while the Chi-square test was applied to measure the significant differences among variables at a 5.00% significant level. Results An outpatient oral opioid, in the form combining paracetamol and codeine, was prescribed for 62 (59%) patients whereas 43 (41%) were discharged on paracetamol only. Conclusions The use of opioids is the practice pattern for pain management among some head and neck or endocrine surgeons despite emerging evidence that supports the use of non-opioid and other alternative analgesic strategies in outpatient thyroid and parathyroid surgery. Further research and quality improvement interventions should be geared towards leading all health professionals to appropriate prescription practices to improve patient safety and reduce unnecessary opioid prescriptions.