Department of Surgery, Division of Otolaryngology Head and Neck Surgery, MSC10 5610, University of New Mexico, Albuquerque, NM 87131, United States of America.
Department of Surgery, Division of Otolaryngology Head and Neck Surgery, MSC10 5610, University of New Mexico, Albuquerque, NM 87131, United States of America.
Am J Otolaryngol. 2022 May-Jun;43(3):103436. doi: 10.1016/j.amjoto.2022.103436. Epub 2022 Apr 5.
Based on a 2018 American Academy of Otolaryngology - Head and Neck Surgery survey, an average of 37 tablets of opioid medication, or about a week's worth of medication, were prescribed after adult tonsillectomy. Nearly 15% of patients will still be taking opioids one year after an initial weeklong prescription, according to data from the Centers for Disease Control and Prevention. Non-steroidal anti-inflammatory medications have traditionally been avoided in adult tonsillectomy patients due to concern for increased bleeding risk from platelet dysfunction, despite little evidence supporting this claim. This study sought to demonstrate that ibuprofen prescriptions after tonsillectomy could be a safe and effective way to reduce postoperative opioid use.
This study was a retrospective chart review of patients undergoing tonsillectomy with one surgeon over three years. Half of the patients received a prescription for postoperative opioid medications and were counseled against taking ibuprofen. The other half of patients were prescribed ibuprofen following surgery and only provided with opioid analgesia as a rescue medication. The New Mexico Prescription Monitoring System was used to verify opioid prescriptions. Descriptive statistics and logistic regression were used to analyze the data.
Ninety-nine patients were included in analysis, with 53 in the first group that did not receive ibuprofen and 46 in the second group that did receive ibuprofen. There was no difference in the bleeding rate between the two groups. Significantly fewer patients in the ibuprofen group filled postoperative opioid prescriptions when compared to the group that did not receive ibuprofen (40% vs. 96.2%, p < 0.0001, OR = 0.02).
Ibuprofen is a safe and effective analgesic following adult tonsillectomy and significantly reduces the proportion of patients who must fill a postoperative opioid prescription.
根据美国耳鼻喉科学会 2018 年的一项调查，在成年人扁桃体切除术后，平均开出 37 片阿片类药物，即大约一周的用药量。根据疾病控制和预防中心的数据，近 15%的患者在最初一周的处方后一年仍在服用阿片类药物。传统上，由于担心血小板功能障碍导致出血风险增加，非甾体抗炎药在成人扁桃体切除术后患者中被避免使用，尽管几乎没有证据支持这一说法。本研究旨在证明扁桃体切除术后开具布洛芬处方可以是一种安全有效的减少术后阿片类药物使用的方法。
这是一项对三年间由一位外科医生进行扁桃体切除术的患者进行的回顾性图表研究。一半的患者收到了术后阿片类药物处方，并被建议不要服用布洛芬。另一半患者在手术后开了布洛芬处方，只提供阿片类镇痛药作为急救药物。新墨西哥州处方监测系统用于验证阿片类药物处方。使用描述性统计和逻辑回归分析数据。
99 名患者纳入分析，其中 53 名患者在未服用布洛芬的第一组，46 名患者在服用布洛芬的第二组。两组的出血率没有差异。与未服用布洛芬的组相比，服用布洛芬的组患者术后开具阿片类药物处方的比例显著降低（40%对 96.2%，p<0.0001，OR=0.02）。
布洛芬是成人扁桃体切除术后一种安全有效的镇痛剂，可显著降低需要开具术后阿片类药物处方的患者比例。
