Evaluating Contemporary Pain Management Practices in Thyroid and Parathyroid Surgery: A National Survey of Head and Neck Endocrine Surgeons

Background There is currently a lack of evidence-based guidelines regarding postoperative opioids after thyroid and parathyroid surgery. This study aimed to objectively characterize contemporary postoperative pain management practices via a national survey of head and neck endocrine surgeons. Methods A standardized electronic survey was distributed to the membership of the American Head and Neck Society's Endocrine section. Results A total of 102 surgeons completed the survey representing a 34% response rate. In all, 65.7% of respondents utilize opioids with wide variations in the total morphine equivalents prescribed. Practice environment (chi(2) = 10.0; P = 0.04) and performing preoperative pain counseling (chi(2) = 9.7; P = 0.002) were significantly associated with a decreased likelihood of prescribing postoperative opioids. Utilization of non-opioid pain management strategies was common and significantly associated with performing outpatient surgery (chi(2) = 6.2; P = 0.013) and preoperative pain counseling (chi(2) = 4.5; P = 0.034). Conclusions Pain management practice patterns vary significantly among head and neck endocrine surgeons which further emphasize the need for evidence-based guidelines.