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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentation 2 - Facial Plastics and Reconstructive Surgery

Analysis of Opioid Prescribing Guidelines on Septorhinoplasty Opioid Prescribing Patterns

Monday, October 13, 2025
9:48 AM - 9:54 AM EDT
Location: 137
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 analyze the prescribing trend of 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 study evaluating de-identified patient data within the TriNetX database from January 1, 2013 to December 31, 2023 from 93 health care institutions in the United States. The study included adult patients who were prescribed either opioid or non-opioid medication 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 on 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).

Conclusions: 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. The lack of sustained change 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)

  • Shahrukh R. Ali, MD

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

    Disclosure information not submitted.

  • 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.

  • Daniel Z. Farishta, MD

    Resident
    Louisiana State University - Shreveport
    Shreveport, LA, United States

    Disclosure information not submitted.

  • Russell W. H Kridel, MD

    Clinical Professor
    University of Texas Medical Branch
    Houston, 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.

    • Senior Author(s)

  • YH

    Yusif Hajiyev, MD, PhD, MBA, MEd

    The University of Texas Medical Branch, United States

    Disclosure information not submitted.