Analgesia After Vestibular Schwannoma Surgery in Europe—Potential for Reduction of Postoperative Opioid Usage
Matthias Gerlitz, Erdem Yildiz, Valerie Dahm, Johannes Herta, Christian Matula, Karl Roessler, Christoph Arnoldner, Lukas D. LandeggerObjective
Excessively prescribed opioids promote chronic drug abuse and worsen a highly prevalent public health problem in the era of the opioid epidemic. This study aimed to (a) determine general analgesic prescription patterns after surgery for vestibular schwannoma (VS) with a focus on opioid prescription rates, (b) identify risk factors for receiving narcotics for postoperative pain management, and (c) highlight the feasibility of opioid-free analgesic treatment strategies.
Study Design
Retrospective chart review.
Setting
Tertiary referral center.
Patients
A total of 105 adult inpatients who underwent VS surgery.
Interventions
Analgesic prescription patterns were evaluated, and factors associated with opioid prescriptions were identified.
Main outcome measure
Number of prescribed analgesics.
Results
Metamizole (=dipyrone) and acetaminophen (=paracetamol) were the most frequently prescribed non-opioid drugs. Sixty-three (60%) patients received an opioid with a median intake of 23.2 ± 24 mg of oral morphine equivalents. Only 10 (9.5%) individuals received opioids for longer than postoperative day 1. Subjects with small tumors undergoing middle cranial fossa tumor removal (
Conclusions
Opioids for acute postoperative analgesia after VS surgery may be necessary in many patients. However, middle- and long-term pain control can be accomplished using non-opioid treatment regimens, resulting in a reduction in opioid prescriptions and the accompanying negative effects on individual and public health.