Evaluating the Impact of Analgesic Guidelines on Opioid Prescribing for Facial Local Flap Reconstruction
Robert E. Africa, Sudhanvan Iyer, Dominik Greda, Brian J. McKinnon, Felix Maldonado-Chapa, Viran J. RanasingheObjective
To evaluate the trends in opioid and nonopioid prescribing for facial local flap reconstruction in relation to the publication of guidelines by the American Academy of Otolaryngology–Head and Neck Surgery in April 2021.
Methods
De-identified patient data were extracted from the TriNetX database, including individuals who received either opioid or non-opioid analgesics within 1–5 days following facial local flap reconstruction between January 1, 2013, and December 31, 2024. Prescribing trends were analyzed using interrupted time series analysis in Statistical Analysis System (SAS) version 9.4, with statistical significance defined as p < 0.05 to compare patterns in relation to the implementation of new opioid prescribing guidelines.
Results
There was an initial significant decrease in the percentage of patients prescribed opioid medication by 4.23% following the publication of the guidelines (SE = 1.85; t = -2.29; p = 0.03). Following the initial period after the guideline publication, the trend continued to decrease by 0.12% per 3-month period (SE = 0.05; t = -2.33; p = 0.02). For non-opioid medication, there were no significant immediate or long-term changes after the guideline publication.
Conclusions
There was an associated decrease in opioid prescribing after facial local flap reconstruction, and this was sustained after the guideline publication. No significant changes were identified for non-opioid prescribing.