Trends in opioid prescribing for septorhinoplasty in relation to the publication of Opioid Analgesia guidelines.

[BACKGROUND] To analyze the prescribing trends for opioid and non-opioid medications postoperatively for septorhinoplasty before and after the release of the April 2021 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) clinical guideline practice on opioid prescribing.

[METHODS] This is a retrospective database study utilizing data from 93 healthcare organizations in the United States. Clinical records including 10 years of data were retrieved from the large multicenter database TriNetX. The study included patients who were prescribed either opioids or non-opioid medications within 1 to 5 days after septorhinoplasty. Prescription trends were evaluated with interrupted time series analysis in Statistical Analysis System (SAS) 9.4, with significance determined at p < 0.05, to assess changes before and after the implementation of prescribing guidelines.

[RESULTS] After the publication of the guidelines, there was an immediate decline in the trend of opioid prescribing for septorhinoplasty by 14.85%, which was statistically significant (p = 0.01). However, the trend over time increased significantly by 0.33% every 3 months (p = 0.03). For non-opioid medications, the trend of prescribing decreased by 4.01%, but was not statistically significant immediately after the intervention (p = 0.07). In the post-intervention period, the trend did increase by 0.11%, but it was not significant (p = 0.05).

[CONCLUSION] The trend of opioid prescribing for septorhinoplasty significantly decreased immediately after the new guideline publication, but the trend reversed with a notable increase in opioid prescription over time. There was no association with the publication of the guidelines and the trend in non-opioid prescription.