Personalization of Opioid Prescription Following Orthognathic Surgery
Pain, Postoperative, Orthognathic Surgery, Opioid Use
About this trial
This is an interventional treatment trial for Pain, Postoperative focused on measuring Personalized Opioid Prescription, Opioid Tapering Protocol, Orthognathic Surgery, Post-Operative Pain, Patient Satisfaction
Eligibility Criteria
Inclusion criteria Patients undergoing orthognathic surgery for the correction of dentofacial deformities. Included in the study will be patients who receive single-jaw surgery (i.e. BSSO [Bilateral Sagittal Split Osteotomy, a surgery of the lower jaw] only, or Lefort [osteotomy of the upper jaw] only), or those in the double-jaw surgery category (BSSO and Lefort). Patients undergoing a functional genioplasty who have an additional osteotomy included in their surgical plan (i.e. BSSO and/or Lefort). Patients undergoing cleft orthognathic surgery. Exclusion criteria Patients who are under the age of 18 at the time of surgery Patients who are contraindicated to undergo elective surgery, including pregnant patients. Patients with a history of opioid use disorder. Patients on chronic opioids within the past month. Patients who have a contraindication for multimodal analgesia (e.g. renal injury precluding the prescription of NSAIDs). Patients with allergies to opioids, acetaminophen, and/or NSAIDs. Patients receiving a surgically-assisted rapid palatal expansion (SARPE) surgery due to the different post-operative nature of the surgery. Patients who have previously undergone prior orthognathic (i.e. repeat surgery), non-cleft craniofacial surgery, or have previously experienced maxillofacial trauma due to the potential alterations in neural pain pathways. Patients undergoing an isolated functional genioplasty. Patients who are unable to consent to surgery and/or the study.
Sites / Locations
- Dalhousie UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Standardized Prescription Group (SOP)
Personalized Prescription Group (POP)
All participants assigned to the SOP group will be treated as per the current status quo, in which they are given the standardized analgesic prescriptions following discharge from the hospital consisting of: Acetaminophen 975 mg orally every 6 hours for 7 days Ibuprofen 600 mg orally every 6 hours for 7 days Hydromorphone 2-4 mg orally every 6 hours as needed, with a total dispense amount of 40mg. The participants are not given instructions on how to taper their hydromorphone medication, which is the current status quo in our department.
All participants assigned to the POP group will receive pre-operative education on the medications that they will be given while they are inpatients and upon discharge, along with a pain medication card to aid their understanding. Medications upon discharge will be: Acetaminophen 975mg orally every 6 hours for 1 week Ibuprofen 600 mg orally every 6 hours for 1 week Hydromorphone - Prescribed with a personalized schedule and tapering protocol based on the participant's last 24-hour in-patient use of opioids. Participants in this arm will also receive tapering instructions as well as an education card to assist them with their tapering protocol upon discharge.