Postoperative Pain Control in Septum and Sinus Surgery

Pain control in the postoperative period following septum and/or sinus surgery is controversial, as there is no consensus statement regarding current guidelines to direct clinical practice. Recent legislation limits opioid prescription length to 5 days only, which brings into question whether legislation will affect prescribing practices of physicians and whether or not giving patients an alternative to opiates will be a more efficacious route.

Current prescribing practices for septum and sinus surgery of the Otolaryngology private practice group includes as-needed acetaminophen 325 mg and as-needed acetaminophen/hydrocodone 7.5 mg/325 mg. If it can be demonstrated that use of 650 mg acetaminophen in scheduled doses of every 6 hours can decrease postoperative opiate use in the first week without significantly increase in patient pain, this may be deployed as an effective strategy of pain control as the use of opiates has come under scrutiny and attempts are being made to decrease or limit the use of these medications in the medical setting.

This study would look to demonstrate that scheduled doses of acetaminophen as opposed to reactionary as-needed acetaminophen can control post-operative pain to the point where narcotics would not be necessary.

Inclusion criteria

• Undergoing primary sinus surgery, primary septum surgery, or primary sinus/septum surgery
• 18 years of age or older
• Male or female
• No known allergies to or contraindications to the use of acetaminophen, hydrocodone, or oxycodone
• Patients discharged to home after surgery

Exclusion criteria

• Undergoing revision sinus, septum, or sinus/septum surgery
• Younger than 18 years old
• Allergy or contraindication to acetaminophen, hydrocodone, or oxycodone
• Patients admitted to the hospital postoperatively for airway monitoring