• Alaa Sada, Amy E Glasgow, Benzon M Dy, Melanie L Lyden, Geoffrey B Thompson, Travis J McKenzie, and Elizabeth B Habermann.
• Department of Surgery, Mayo Clinic, 200th 1st Street, Rochester MN, 55905, USA; Department of Health Services Research, Mayo Clinic, 200th 1st Street, Rochester MN, 55905, USA.
• Am. J. Surg. 2021 Feb 1; 221 (2): 455-459.

IntroductionIn 2018, our institution implemented opioid prescribing guidelines for endocrine surgery.MethodsWe evaluated prescribing trends before and after the guidelines (60 MME following adrenal procedures and 37.5 MME for thyroid/parathyroid procedures) using chi-squared and Wilcoxon Rank-Sum tests.ResultsWe identified 357 patients in the pre-guideline and 397 in the post-guideline period. The proportion discharged with any opioid prescription decreased from 96.1% to 77.3%, p < 0.01, and the median (IQR) prescribed amount decreased from 150.0 (100.0, 200.0) to 50.0 (25.0, 75.0), p < 0.01 overall and within each category. The proportion receiving prescription above the upper guidelines limit also decreased, while opioid refills within 30-day of discharge remained stable (2.8% before and 4.5% after the guidelines, p = 0.21).ConclusionOpioid prescribing guidelines for endocrine surgical procedures decreased both the proportion of patients receiving opioids and the amount when prescribed, therefore further supporting the utility of opioid prescribing guidelines in decreasing over-prescription.Copyright © 2020 Elsevier Inc. All rights reserved.

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