Analysis of Opioid Prescribing Guidelines on Opioid Prescription Trends for Major Pediatric Ear Surgeries

Sunday, October 18, 2026

8:30 AM - 8:36 AM PT

Location: 409AB

Presenting Author(s)

Robert E. Africa, MD

Resident
The University of Texas Medical Branch
Galveston, TX, United States

Co-Author(s)

Shahrukh R. ali, MD

Shahrukh Ali
University of Texas Medical Branch
Richmond, TX, United States
CH

Charles Hughes, MD, MPH, MBA

Professor
The University of Texas Medical Branch
galveston, Texas, United States
DY

Dayton L. Young, MD

Associate Professor and Director of Quality and Value, Department of Otolaryngology
University of Texas Medical Branch
Galveston, Texas, United States
HP

Harold S. Pine, MD

Professor Pediatric Otolaryngology
University of Texas Medical Branch
Galveston, Texas, United States
Brian J. McKinnon, MD, MBA, MPH

Chair of Surgery
Meritus Health
Hagerstown, Maryland, United States

Senior Author(s)

YH

Yusif Hajiyev, MD, PhD, MBA

Associate professor
The University of Texas Medical Branch at Galveston, United States

Disclosure(s):

Harold S. Pine, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brian J. McKinnon, MD, MBA, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Widespread overprescribing of opioids in the United States has raised concerns about an opioid epidemic, and this has driven efforts to develop multimodal treatment plans, emphasize patient education, and reduce prescribing. This study aims to analyze the trends in opioid and non-opioid prescribing for major pediatric ear surgeries before and after the publication of opioid prescribing guidelines by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) in April 2021.

Methods: This retrospective study utilized de-identified patient data obtained from the TriNetX database including pediatric patients who were prescribed either opioid or non-opioid analgesics within 1-5 days following tympanoplasty with or without mastoidectomy, cochlear implantation, and otoplasty from January 1, 2016 to December 31, 2024. Interrupted time series analysis in Statistical Analysis System (SAS) 9.4 was used to evaluate the trends of prescription before and after the new guidelines with significance at p < 0.05.

Results: The rate of opioid prescribing for major pediatric ear surgeries increased by 0.52% per year before the guideline change, then declined to 0.06% annually after its publication (p < 0.0001), with this reduction sustained through December 31, 2024. Conversely, non-opioid prescriptions were initially decreasing by 0.15% per year but rose by 0.14% annually following the guideline change (p = 0.003), with this increase also maintained long-term.

Conclusions: Long term significant changes to the pain medication prescribing rates were observed, as demonstrated by an associated decrease in the opioid prescribing rate for major pediatric ear surgeries and increase in non-opioid prescribing rate. Continued education and maintenance of multimodal pain management utilizing non-opioid medication is recommended.