Pain Management Following Sinus Surgery

National attention has been given to the concerning rise of opioid abuse in this country,
with prescriptions for this medications more than quadrupaling in the last 17 years.

Little is known as to the appropriate use of opioid analgesics in the post-operative recovery
of patients undergoing sinus surgery. Furthermore, most pain protocols include only Tylenol
based opioid analgesics. No study has prospectively evaluated the volume of use of Tylenol
based opioid analgesics and whether the addition of NSAIDS decreased the need for opioid
analgesics.

This study will compare opioid use with and without the addition of NSAIDS following sinus
surgery.

Post-operative opioid use is a great public health concern, relatively unstudied, and an area
with an opportunity for potential intervention to significantly reduce risks, morbidity, and
mortality to our postoperative patients by better formulating a postoperative pain management
plan using evidence-based practices. Appropriate opioid prescribing practices can reduce the
risk of addiction, drug overdose, death, and undertreated pain. By optimizing post-operative
pain management protocols, the need for opioids following sinus surgery should be minimized.

Inclusion Criteria:

- All patients age 18-65 undergoing functional endoscopic sinus surgery +/- nasal airway
surgery (septoplasty and/or inferior turbinate reduction).

Exclusion Criteria:

Anti-coagulation medications including aspirin Aspirin-exacerbated respiratory disease
Cystic Fibrosis Primary Ciliary Dyskinesia Inclusion of a Draf III frontal sinusotomy
Liver/Kidney Failure Thrombocytopenia Poorly controlled hypertension Recent GI ulcers or
gastritis Chronic pain as defined by a narcotic prescription with 6 months or involvement
in a pain management program Primary Headache disorder The use of nasal decongestants in
the post-operative period. The use of nasal packing or absorbable biomaterials.