Patients undergoing lateral neck dissections for thyroid cancer with short hospital stays required little, if any, post-operative opioids for managing pain, according to findings published in JAMA OtolaryngologyHead & Neck Surgery. Maisie L. Shindo, MD, and colleagues compared the effect of a multi-modal intervention to decrease opioid prescribing among 171 patients (mean age, 47.1; 61% women) before (group 1) and 246 patients (mean age, 46.2; 60% women) after (group 2) the intervention. Median oral morphine milliequivalents (MME) prescribed at discharge per patient were 225 for group 1 versus 0 MME for group 2, indicating a large effect-size difference. The researchers reported a moderate association between the dose given to an inpatient and the dose at discharge (r, 0.33). Multiple linear regression analysis of sex, age, race, ethnicity, extent of surgery, and opioid reduction intervention demonstrated that the intervention had a large, clinically meaningful association with reducing opioid prescriptions and dosages at discharge (etasquared effect size, 0.26; 95% CI, 0.19-0.33).

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