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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentation 3 - Care Equity, Quality and Safety

Evaluation of Opioid Prescribing Guidelines on Opioid Prescription Trends for Parotidectomy

Monday, October 13, 2025
10:06 AM - 10:12 AM EDT
Location: 107-108
Disclosure(s):
Robert E. Africa, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amber M. Dunmire, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brian J. McKinnon, MD, MBA, MPH, FACS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: To evaluate the trends in opioid and nonopioid prescription rates for parotidectomy before and after the guideline recommendations by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in April 2021.

Methods: This is a retrospective study utilizing de-identified patient data within the TriNetX database from January 1, 2016 to December 31, 2023 in intervals of 3 months. Patients included in the study were either prescribed opioid or nonopioid analgesic within 1-5 days following parotidectomy. Data were collected from 80 participating health care institutions in the database. Statistical interrogation was performed by interrupted time series analysis in Statistical Analysis System (SAS) 9.4 with significance set at p < 0.05 to assess trends before and after the AAO-HNS opioid prescribing guidelines.

Results: A total of 25,076 patients were included in the study. The number of patients prescribed opioid analgesic was 11,615 (46%), while 1,668 patients (7%) were only prescribed nonopioid analgesic following parotidectomy. For opioid prescription, there was no immediate effect or sustained change for the trend of parotidectomy postoperative prescribing. The rate before the guideline change was -0.40 cases per year and after was -0.20 cases per year (p = 0.50). For nonopioid prescribing, the trend after the guideline publication was significantly less at -0.08 cases per year compared to before the new guidelines at 0.25 cases per year (p = 0.0004)

Conclusions: After the guideline publication in April 2021, there was no reduction in the opioid prescribing trend for parotidectomy, as well as no increase in nonopioid prescribing. The lack of changes signifies a continued need for ongoing development of multimodal pain management protocols and patient education about postoperative pain.

    Presenting Author(s)

  • Robert E. Africa, MD

    Resident
    University of Texas Medical Branch Hospitals
    Galveston, TX, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Amber M. Dunmire, MD

    Resident
    University of Texas Medical Branch Hospitals
    Galveston, TX, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Shahrukh R. Ali, MD

    Resident
    University of Texas Medical Branch Hospitals
    Richmond, TX, United States

    Disclosure information not submitted.

  • BM

    Brian J. McKinnon, MD, MBA, MPH, FACS

    Professor, Neurotology
    University of Texas Medical Branch at Galveston
    Galveston, TX, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Sepehr Shabani, MD

    Assistant Professor
    City of Hope National Medical Center
    Duarte, California, United States

    Disclosure information not submitted.

  • Orly M. Coblens, MD

    Associate Professor & Residency Program Director
    University of Texas Medical Branch Hospitals
    Galveston, Texas, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Viran J. Ranasinghe, MD

    Assistant Professor
    University of Texas Medical Branch
    Galveston, TX, United States

    Disclosure information not submitted.