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CPG: Opioid Prescribing for Analgesia After Common Otolaryngology Operations – Research Needs

CPG: Opioid Prescribing for Analgesia After Common Otolaryngology Operations – Research Needs

Research Needs section from CPG Opioid Prescribing for Analgesia After Common Otolaryngology Operations.


Development of this guideline was based on the current body of evidence regarding the opioid-prescribing practices for common otolaryngologic procedures. As determined by the Guideline Development Group’s review of the literature, assessment of current clinical practices, and determination of evidence gaps, research needs were determined as follows:

  1. What are the benefits of preoperative counseling on postoperative pain outcomes?
  2. What is the duration and severity of pain for specific otolaryngology surgical procedures?
  3. How do specific procedural and patient factors modify postoperative pain?
  4. In patients at risk for increased postoperative pain, how is that effectively managed?
  5. What is the optimal way to counsel patients preoperatively?
  6. How have prescription-monitoring-programs influenced management of postoperative pain?
  7. Are there specific predictors of OUD in otolaryngologic surgical patients?
  8. How do opioid risk assessment and postoperative prescribing differ in the pediatric otolaryngologic population?
  9. What interventions reduce risk of OUD for patients after surgery?
  10. Is gabapentin helpful to control postoperative pain and reduce opioid use in otolaryngology patients?
  11. Are some otolaryngology patients at higher risk for cardiovascular morbidity from COX-2 inhibitors?
  12. Which otolaryngology surgical procedures are associated with prolonged opioid use and symptoms of postoperative opioid withdrawal?
  13. What is the risk of bleeding after surgery, by procedure, when using ibuprofen postoperatively?
  14. What specific combinations of medications optimally balance pain control, risks, and cost?
  15. Are scheduled doses of acetaminophen and NSAIDs superior to as-needed regimens?
  16. Does staggering the timing of acetaminophen and NSAIDs improve postoperative pain control?
  17. What are the current trends in opioid prescribing for otolaryngologic surgery, and what are the key factors (eg, patient awareness, patient education, provider awareness, and provider education) that affect the trends?
  18. When nonopioids are used as first-line therapy, what is the impact on opioid consumption?
  19. What are the usual durations for opioid therapy after each of the most common otolaryngologic surgical procedures?
  20. What is the best strategy to de-escalate postoperative pain treatment?
  21. What percentage of patients dispose of unused opioids after recovery from otolaryngologic surgery?
  22. What is the most effective educational approach to promote disposal of unused opioids?
  23. Do the expectations of the duration and severity of surgical pain by providers correlate with postoperative assessments by patients?
  24. What are optimal measurements/scales for pain and indicators for quality of recovery after otolaryngology surgery?
  25. Are there racial or gender biases that impact the prescribing of opioids, the education about opioids, or risk of developing OUD after surgery?
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