8
Management
Table 5. Distribution in Opioid Consumption After Common
Otolaryngology Operations
a
Patients Mean (Median)
N Oxycodone 5mg Tablets Consumed
Adult
Tonsillectomy 340 31.2 (22.8)
Mandibular fracture 60 15.2
Septoplasty +/− turbinate reduction 223 9.7
Rhinoplasty +/− septoplasty 98 8.5
Endoscopic sinus surgery + septoplasty 206 7.7
Endoscopic sinus surgery 147 4.9 (0)
Turbinate reduction 18 8.9
Otolog y surgery
c
140 6.1 (6.7)
Parotidectomy 37 5.7
yroidectomy 677 2.8 (0)
Parathyroidectomy 149 0.2
Microdirect laryngoscopy 60 0.5
Adolescent (age 12–18 years)
Adolescent tonsillectomy 66 11.3
Adolescent septoplasty 22 6.3
Adolescent endoscopic sinus surgery 19 3.3
Pediatric (age ≤12)
Mean MME/kg (doses)
Pediatric adenotonsillectomy
(age 5–12 years)
285 0.9 (4.3)
Pediatric myringotomy and tube
placement (age 6 months to 8 years)
120 0.001/kg
Total 2667
a
Mean, median, 75th percentile, and approximate 85th percentile are reported. e 85th percentile for
opioid consumption was approximated based on combining the mean and standard deviations, however,
this may vary depending on the degree to which opioid consumption distribution is skewed.
b
e maximum recommended dose in the range is designed to provide enough pain medicine for
approximately 80% of patients informed by the 75th percentile and ~85th percentiles. Patients treated
with multimodal nonopioid analgesia (acetaminophen and NSAIDs) may require significantly less than
the maximum recommended dose or no opioids. ere is significant variability in opioid consumption
depending on patient factors and preferences, and it is advised that prescribers adapt these recommendations
into their own practice. Clinical factors known to be associated with increased pain aer surgery may
provide a rationale for prescribing more than the recommended maximum dose.
