Sleep & Snoring Archives - ENT Health https://www.enthealth.org/health_and_wellness_categories/sleep-snoring-latest-research-guidelines/ Mon, 14 Aug 2023 18:55:05 +0000 en-US hourly 1 https://wordpress.org/?v=6.8.3 249128111 FAQs Comparing Nonopioid and Opioid Medications https://www.enthealth.org/be_ent_smart/faqs-comparing-nonopioid-and-opioid-medications/ Tue, 06 Apr 2021 06:00:44 +0000 https://www.enthealth.org/?post_type=be_ent_smart&p=2170 From the Clinical Practice Guideline: Opioid Prescribing for Analgesia after Common Otolaryngology Operations, this information provides answers to frequently asked questions comparing nonopioid and opioid medications.

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FAQs Comparing Nonopioid and Opioid Medications

NSAIDs = Nonsteroidal Anti-inflammatory Drugs

Can I Be Addicted to This?

  • Opioids: Yes
  • NSAIDs: No
  • Acetaminophin: No
  • Gabapentinoids: Yes

When Are They Used? What Levels of Pain?

  • Opioids: Severe
  • NSAIDs: Mild-Severe
  • Acetaminophin: Mild-Severe
  • Gabapentinoids: Mild-Moderate

Should I Start with This Medication?

  • Opioids: No, use only if around-the-clock nonopioid medications are not enough.
  • NSAIDs: Yes, you may start with this medication.
  • Acetaminophin: Yes, you may start with this medication.
  • Gabapentinoids: No, only use if NSAIDs and/or acetaminophen is not enough.

Is This Used Alone or with Other Medications?

  • Opioids: Should be used in combination with other pain medications.
  • NSAIDs: Can be used alone or in combination.
  • Acetaminophin: Can be used alone or in combination.
  • Gabapentinoids: Should be used in combination with other pain medications.

Can I Stop Using This Medication and How Do I Stop?

  • Opioids: Sometimes this needs to be slowly stopped (“tapered”) depending on how much you have taken. Talk about this with your health care provider.
  • NSAIDs: This can be stopped at any time.
  • Acetaminophin: This can be stopped at any time.
  • Gabapentinoids: Sometimes this needs to be slowly stopped (“tapered”) depending on how much you have taken. Talk about this with your health care provider.

What Are the Common Side Effects (Reported in 3% or More of Patients)?

  • Opioids: Dizziness, nausea (very common), headache, drowsiness (feeling sleepy or tired), vomiting, dry mouth, itching, and constipation.
  • NSAIDs: Upset stomach. 
  • Acetaminophin: Nausea, vomiting, headache, and insomnia (being unable to sleep).
  • Gabapentinoids: Dizziness, drowsiness (feeling sleepy or tired), swelling in the hands and feet, weight gain, and blurred vision.

What Are the Serious Risks and What is the Risk of Addiction or Dependence?

  • Opioids: Respiratory depression (very slow breathing), misuse, abuse, addiction, overdose, and death from respiratory depression. Your risk of opioid abuse increases the longer you take the medication.
  • NSAIDs: Stomach bleeding or ulcers, heart attack, kidney damage, and stroke. Celecoxib has a lower risk of stomach bleeding and/or ulcer formation over the short term.
  • Acetaminophin: Liver damage may occur at high doses (greater than 3,000 milligrams in 24 hours).
  • Gabapentinoids: Suicidal thoughts, respiratory depression. Risks increase if you have kidney, liver, or heart disease or have suicidal thoughts.

SOURCE: Anne SA, Mims JW, Tunkel DE, et al. Clinical practice guideline: opioid prescribing for analgesia after common otolaryngology operations. Otolaryngol Head Neck Surg. 2021;164(2_suppl):S1-S42.

Related Conditions

FAQs about Opioids

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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]]> 2170 FAQs: Rhinoplasty Patients with Obstructive Sleep Apnea (OSA) https://www.enthealth.org/be_ent_smart/faqs-rhinoplasty-patients-with-obstructive-sleep-apnea-osa/ Wed, 03 Oct 2018 19:42:18 +0000 http://www.enthealth.org/?post_type=be_ent_smart&p=1385 Read frequently asked questions about rhinoplasty for patients with Obstructive Sleep Apnea (OSA).

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FAQs: Rhinoplasty Patients with Obstructive Sleep Apnea (OSA)

Should I Bring My CPAP with Me to Surgery?

Depending on the type, extent of your surgery, and if you will be staying overnight in the hospital, your surgeon may or may not have you wear your CPAP1. To be prepared, you should bring your CPAP with you, but understand that you may not use it immediately after surgery.

When Should I Resume Using My CPAP?

When to resume using your CPAP depends on the type and extent of your surgery. Because this decision is individualized, you should ask your care provider about the appropriate timing to resuming your CPAP use.

If I Cannot Use My CPAP, What Are My Choices?

You may be able to continue using your CPAP but with a different mask. Other treatment options range from avoiding sleeping on your back (using various barrier devices) and sleeping with the head of the bed elevated, if possible. Other treatment options may also include using a mouth-piece designed to thrust the lower jaw forward or an implanted stimulator. These latter options will often need several months to coordinate care and will need to be planned accordingly.

Your sleep medicine care provider may discuss the appropriateness of these options with you. While some patients may use oxygen alone, this may not be appropriate for most patients with sleep apnea.

Will Surgery Help My Sleep Apnea?

There is a possibility that the severity of your sleep apnea may improve slightly and the required pressure on your CPAP may be reduced, but this is not consistently the case.

Source

Ishii LE, Tollefson TT, Basura GJ, et al. Clinical Practice Guideline: Improving Nasal Form and Function after Rhinoplasty. Otolaryngol Head Neck Surg. 2017; 156(2_suppl):s1-s30.

1Continuous positive airway pressure (CPAP) device—these questions apply to any positive airway pressure devices such as bilevel positive airway pressure (BiPAP), adaptive servo ventilator (ASV), average volume-assured pressure support (AVAPS), intelligent volume-assured pressure support (iVAPS), and Trilogy.

Related Conditions

Deviated Septum

Nasal Surgery: Fixing Form and Function

Snoring, Sleeping Disorders, and Sleep Apnea

The information on ENThealth.org is provided solely for educational purposes and does not represent medical advice, nor is it a substitute for seeking professional medical care.

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