title: Use of opioid pain relievers following extraction of third molars.
abstract: Following extraction of third molars, it is common practice for oral and maxillofacial surgeons to provide a prescription for an opioid-containing analgesic such as hydrocodone with acetaminophen. Because the instructions for use most often indicate that these analgesics are to be taken "as needed for pain," it is unknown how many of the prescribed postoperative analgesic tablets are needed and actually taken. Therefore, an assessment of patient pain experiences and actual opioid analgesic usage was carried out using structured telephone interviews of patients performed 1 and 7 days following their thirdmolar extraction surgery. Forty-eight adolescents and young adults, ages 15 to 30 years, participated in this assessment. A review of the surgeon's notes indicated that the median number of prescribed opioid-containing analgesics (ie, Vicodin®, Norco®, Lorcet®, Percocet®) was 20 tablets (range 10 to 40). The median consumption during the first 24 hours was reported to be three tablets (range 0 to 10), and the total consumption for all 7 days was eight tablets (range 0 to 34). Four patients reported nausea or vomiting in the first 24 hours, and six patients reported nausea or vomiting during the following 6 days of recovery. The initial prescriptions provided adequate relief for 45 of the 48 patients. Higher consumption of opioid pain relievers (OPRs) was associated with a longer duration of surgery and the occurrence of postoperative infections.
authors.affiliation: Resident, Division of Dental Anesthesiology, Department of Anesthesiology, Stony Brook University School of Dental Medicine, Stony Brook, New York.
authors.forename: Breanna M
authors.initials: BM
authors.lastname: Weiland
authors.affiliation: Resident, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Wach
authors.affiliation: Resident, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
authors.forename: Brent P
authors.initials: BP
authors.lastname: Kanar
authors.affiliation: Resident, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Castele
authors.affiliation: Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Sosovicka
authors.affiliation: Assistant Professor, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Cooke
authors.affiliation: Professor, Department of Dental Anesthesiology, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid