Opioid Usage Following Oculoplastic Procedures

Abstract

Background: With the rising toll of the opioid crisis, oculoplastic surgeons have been looking at methods to decrease opioid prescription.

Objectives: To identify factors that correlate with opioid usage after oculoplastic surgery.

Methods: This is a prospective study conducted at University of Texas Southwestern. All patients that undergo an oculoplastic procedure were eligible for inclusion. Patients enrolled were provided 20 tablets of tramadol 50 milligram, one tablet every 6 hours as needed for pain. At their post-operative week 1 (POW1) appointment, participants had the remaining number of unused opioid tablets counted. The number of tablets taken were calculated by subtracting the remaining number of tablets from the original prescribed amount.

Results: 310 patients were enrolled in our study. 129 patients met inclusion criteria. There was a statistically significant difference in the number of tramadol tablets taken between upper eyelids, lower eyelids, and both eyelids (p < 0.01). There was no statistically significant difference in tramadol usage when comparing procedures on eyelids to orbit (p = 0.30), cosmetic to non-cosmetic procedures (p = 0.52), male to females (p = 0.87), patients naïve to oculoplastic procedures and those undergoing reoperation (p = 0.58). Longer procedures were correlated with greater tramadol usage (R = 0.28, p < 0.01).

Conclusions: This is the first study in the literature that objectively quantifies opioid usage after oculoplastic surgery in a prospective manner. Procedures that involve both upper and lower eyelids simultaneously and longer procedures resulted in higher opioid use. Orbital procedures, cosmetic procedures, sex, and procedural naivety were not found to be associated with higher opioid usage.