Document Type
Article
Publication Date
12-20-2023
Abstract
OBJECTIVE: To evaluate the association of postoperative naloxone with the development of new substance use disorder (SUD), overdose, and death within 6 months of otolaryngologic surgery.
STUDY DESIGN: Retrospective cohort database study on TriNetX.
METHODS: Adult patients who underwent tonsil surgery (noncancerous), thyroid/parathyroid, septorhinoplasty, otology/neurotology, sinus/anterior skull base, and head and neck cancer surgeries between January 2003 and April 2023. Patients were excluded if they had an instance of SUD or overdose recorded in their charts prior to surgery, or had undergone another surgery within that 6-month time frame. We hypothesized that patients prescribed naloxone postoperatively would have decreased odds for experiencing new SUD, overdose, and/or death within 6 months of surgery compared to patients who did not receive naloxone. P < .01 was considered statistically significant.
RESULTS: There were 2,305,655 patients in this study. The average age was 36.7 ± 19.5 years old, with 46% female patients. Before matching, cohorts showed equivocal odds for developing new SUD, increased odds for overdose, and mixed odds for dying. After matching for demographic variables and comorbidities such as other substance use, opioid use for other pathologies, and psychiatric conditions, these effects diminished (P > .01).
CONCLUSION: Our results suggest that postoperative naloxone may not significantly affect development of new SUD and incident overdose and death in certain otolaryngologic surgeries after controlling for prior SUD and psychiatric conditions. Clinicians should be aware of these comorbidities when considering their postoperative pain management protocol, which may or may not include naloxone.
Recommended Citation
Perlov, Natalie M.; Shah, Sohan S.; Bluj, Joann; Urdang, Zachary D.; and Chiffer, Rebecca C., "The Effect of Postoperative Naloxone in Certain Otolaryngologic Surgeries" (2023). Department of Otolaryngology - Head and Neck Surgery Faculty Papers. Paper 93.
https://jdc.jefferson.edu/otofp/93
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
38123881
Language
English
Comments
This article is the author's final published version in Otolaryngology–Head and Neck Surgery, Volume 170, Issue 5, May 2024, Pages 1289-1295.
The published version is available at https://doi.org/10.1002/ohn.625. Copyright © 2023 The Authors. Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.
Publication made possible in part by support through a transformative agreement between Thomas Jefferson University and the publisher.