Pain Medications Following Thyroidectomy and Parathyroidectomy

The purpose of this study is to evaluate the use of a non-narcotic, postoperative pain
management regimen for patients undergoing thyroidectomy and parathyroidectomy. The
investigators hypothesize that participants receiving non-narcotic pain regimens will have
equivalent pain control and satisfaction to those who receive narcotic pain medicines.

The primary objective will be to identify if there is a difference in average perceived
postoperative pain scores between participants who do and do not receive narcotic pain
medications. Secondary outcomes will include need for breakthrough pain medications, patient
satisfaction scores and the need to call the surgeon office for additional pain medications.

The participant will undergo total thyroidectomy, partial thyroidectomy or parathyroidectomy
per the standard of care. The study will have no influence on the surgical procedure
performed.

Following the surgery, postoperative analgesia regimens will be prescribed based on study
randomization.

Narcotic group regimen (63 patients):

- Tylenol tablet 1000 mg by mouth every 8 hours alternating with

- Ibuprofen tablet 800 mg by mouth every 8 hours

- Oxycodone 5 mg by mouth every 6 hours as needed for pain, #10 tablets

Non-narcotic group regimen (63 patients):

- Tylenol tablet 1000 mg by mouth every 8 hours alternating with

- Ibuprofen tablet 800 mg by mouth every 8 hours

Participants will be asked to complete a survey each day for the initial 5 days
postoperatively. Survey data includes:

- Average pain level using the 10-point visual analogue scale

- Ease of following the pain regimen using a 3-point liker scale

- Total dose of oral narcotics converted into oral morphine equivalents that were taken by
participants post-operatively

- If the patient needed to call the office due to inadequately controlled pain

If the participants do not have adequate pain control with the non-narcotic regimen, they may
be prescribed additional narcotic pain medication at the discretion of the PI and remain
enrolled in the study.

The investigators will also review participants charts for information regarding any
postoperative office calls regarding postoperative needs (i.e. for pain medications).

The medical surgical information below is gathered as standard of care for each surgical
procedure and will also be collected as part of this procedure:

- Patient name, medical record number

- Patient demographics (age, gender, BMI, ASA score)

- Past medical History

- Past surgical history

- Past social history

- Preoperative medications (including steroids, anticoagulation, opioid use)

- Pre-operative diagnosis

- Procedure performed and pain medications administered in the post-ambulatory care unit

- Postoperative complications including need for readmission within 30 days

- Length of stay in hospital

Inclusion Criteria:

- Age 18 years or greater

- Undergoing total thyroidectomy, partial thyroidectomy or parathyroidectomy at
MetroHealth Medical Center

Exclusion Criteria:

- Patients taking narcotics prior to surgery

- Patients who are unable or unwilling to follow study protocol requirements