Clinical oral investigations
Postoperative pain outcomes following minor oral surgery in opioid tolerant patients: a retrospective cohort study
By Gopinath A, Ayeni FE and Cox S.
Abstract
Background
Evidence guiding postoperative pain management in patients taking prescription or illicit opioids undergoing minor oral surgery is limited. It remains unclear whether standard analgesic protocols for opioid naïve patients provide adequate pain relief in opioid tolerant individuals. This study evaluated whether standard postoperative analgesia achieves adequate pain control in opioid tolerant patients undergoing minor oral surgery with expected mild to moderate pain.
Methods
A single centre retrospective study was conducted of patients undergoing minor oral surgical procedures at a public oral surgery service between May 2020 and May 2024. Patients were classified as opioid tolerant if prescribed opioids for longer than one month, receiving methadone therapy, reporting current illicit opioid use, or having a documented history of opioid use disorder. Opioid naïve patients served as controls. Standard postoperative analgesia consisted of paracetamol and non-steroidal anti-inflammatory drugs unless contraindicated. The primary outcome was return with postoperative pain requiring additional opioid analgesia.