A multimodal analgesic protocol may reduce opioid use after third molar surgery: A pilot study

Objective This study was designed to assess the number of opioid doses available to patients from filled prescriptions after adoption, in 2017, of a multimodal analgesic protocol that included opioid prescribing to manage postoperative pain. Study Design Data were retrieved from records of the first 24 patients having third molar surgery in 2017 identified from appointment schedules. Inclusion criteria were American Society of Anesthesiologists risk classification I or II, age 18 to 35 years, and at least 2 lower third molars removed. The exclusion criterion was being treated for opioid addiction/abuse. The primary outcome variable was the number of opioid doses filled by prescriptions at each patient's discretion. The primary predictor variable was the multimodal analgesic protocol. Results Data from records of 24 consecutive patients were analyzed; 83% were females. Median age was 25 years (interquartile range [IQR] 12-29 years). Median surgery time was 35 minutes (IQR 27-32 minutes). The median number of opioid doses filled in 2017 was 4 (IQR 0-4). Conclusions The outcomes from this pilot study suggest that implementation of a multimodal analgesic protocol to manage postoperative pain, while limiting the number of opioid doses available to the patient, may be an effective strategy for a wider range of patients and procedures.