ORCID

0000-0001-6487-1567 (Frederick), 0000-0002-5758-9050 (Dobratz)

Document Type

Article

Publication Date

2025

DOI

10.21037/joma-24-35

Publication Title

Journal of Oral and Maxillofacial Anesthesia

Volume

4

Pages

6 (1-10)

Abstract

Background and Objective: Opioids are routinely prescribed following septorhinoplasty and oftentimes surgeons prescribe a larger number of tablets than patients require. Considering the high risk of developing opioid dependence and risk of diversion, it is imperative that surgeons practice safer, evidence-based prescribing habits. This review is intended to detail the current state of opioid usage after septorhinoplasty, focusing on articles that show pertinent and practice-altering findings. This will allow surgeons to reflect on their prescribing patterns and make evidence-based decisions to improve them.

Methods: A literature search was performed in November 20, 2024 via PubMed using keywords such as ‘opioid use in septorhinoplasty’, ‘pain septorhinoplasty’, ‘rhinoplasty opioids’, and ‘narcotics septorhinoplasty’ and articles published within 01/01/2004–11/20/2024 were included in order to determine current trends in opioid usage after septorhinoplasty. Articles included in the review were English or had available English translations.

Key Content and Findings: Many of the studies describe a contrast between the number of opioids prescribed and the number of opioids patients actually require to treat post-septorhinoplasty pain. There are many alternative (non-narcotic) analgesic regimens under active investigation, including variations of nonsteroidal anti-inflammatory drugs (NSAIDs), gabapentin, ketamine, nerve blocks, esmolol, and alpha agonists.

Conclusions: The literature demonstrates a common pattern of over-prescribing opioids following septorhinoplasty. The majority of patients only require less than 10 5-mg opioid tablets. Patient characteristics that may result in a higher than average required postoperative opioid consumption include previous opioid use or high anxiety towards pain. There are numerous other studies describing the countless alternative analgesic regimens that have been shown to be safe and efficacious in treating post septorhinoplasty pain. This review will allow surgeons to reflect on their prescribing patterns and make evidence-based decisions to improve them.

Rights

© 2025 AME Publishing Company.

This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license).

Original Publication Citation

Frederick, R. M., & Dobratz, E. (2025). Opioid usage and non-opioid alternatives in septorhinoplasty: A narrative review. Journal of Oral and Maxillofacial Anesthesia, 4, 1-10, Article 6. https://doi.org/10.21037/joma-24-35

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