3
Management
Table 1. Summary of Key Action Statements (KAS)
Statement Action Grade
1. Expected Pain Prior to surgery, clinicians should advise
patients and others involved in the
postoperative care about the expected
duration and severity of pain.
Recommendation
2. Modifying
Factors
Prior to surgery, clinicians should gather
information specific to the patient that
modifies severity and/or duration of pain.
Recommendation
3A. Risk
Factors for
Opioid Use
Disorder
Prior to surgery, clinicians should identify
risk factors for Opioid Use Disorder (OUD)
when analgesia using opioids is anticipated.
Strong
Recommendation
3B. Patients at
Risk for
OUD
In patients at risk for OUD, clinicians should
evaluate the need to modify the analgesia plan.
Recommendation
4. Shared
Decision
Making
Clinicians should promote shared decision
making by informing patients of the benefits
and risks of postoperative pain treatments that
include nonopioid analgesics, opioid analgesics,
and nonpharmacologic interventions.
Recommendation
5. Multimodal
erapy
Clinicians should develop a multimodal
treatment plan for managing postoperative pain.
Recommendation
6. Nonopioid
Analgesia
Clinicians should advocate for nonopioid
medications as first-line management of pain
aer otolaryngologic surgery.
Strong
Recommendation
7. Opioid
Prescribing
When treating postoperative pain with opioids,
clinicians should limit therapy to the lowest
effective dose and the shortest duration.
Recommendation
8A. Patient
Feedback
Clinicians should instruct patients and
caregivers how to communicate if pain is not
controlled or if medication side effects occur.
Recommendation
8B. Stopping
Pain
Medications
Clinicians should educate patients to
stop opioids when pain is controlled with
nonopioids and stop all analgesics when pain
has resolved.
Recommendation
9. Storage and
Disposal of
Opioids
Clinicians should recommend that patients
(or their caregivers) store prescribed opioids
securely and dispose of unused opioids
through take-back programs or another
accepted method.
Strong
Recommendation
10. Assessment
of Pain
Control with
Opioids
Clinicians should inquire, within 30 days of
surgery, whether the patient has stopped using
opioids, has disposed of unused opioids, and
was satisfied with the pain management plan.
Recommendation
