Patient's pain level and narcotic requirements will be evaluated after routine outpatient Otolaryngology procedures. This will be done by having study participants record their pain level and medication usage from home.

It is routine practice to give narcotic medication after surgery for pain control however the abuse of prescription medications has become the fastest growing drug problem in the United States. Research has shown that post operative pain for some common Ear, Nose, and Throat (ENT) procedures are not severe but there is limited data looking at patient narcotic needs and their usage pattern to help inform physicians on how much to prescribe.

The objective of this study is to evaluate patient pain level in the immediate post-operative period and quantify pain medication usage in patients who undergo outpatient ENT surgeries.

Patients who undergo the following procedures will be invited to participate: thyroidectomy, parathyroidectomy, parotidectomy, tympanoplasty, mastoidectomy, endoscopic sinus surgery, and septoplasty. All patients will receive Hydrocodone/acetaminophen and Ibuprofen in standard dosage and assigned to one of two groups before surgery. Group 1 will use the narcotic medication for pain control and ibuprofen for breakthrough pain. Group 2 will use ibuprofen for pain control and the narcotic medication for breakthrough. Patients will fill out a data sheet for 7 days recording their pain level three times per day as well as pain medication usage for each day. This will be collected on their first clinic visit after surgery at which point the patient's involvement is completed.

Inclusion Criteria:

Patients undergoing one of the following outpatient procedure:

• Septoplasty
• Unilateral or Bilateral Functional endoscopic sinus surgery
• Tympanomastoidectomy
• Tympanoplasty
• Total or Partial Thyroidectomy
• Parathyroidectomy
• Parotidectomy.
• Age >18 years and < 89 years

Exclusion Criteria:

• Age < 18 years or > 89 years
• Post operative hospital admission
• Allergy to Hydrocodone
• Allergy or contraindication to Ibuprofen or NSAIDs
• Pregnancy
• Hepatic disease
• Chronic kidney disease
• Sickle cell anemia

Collected data will be analyzed and published. Meaningful data will be available through published material.

Patients who completed and returned pain data entry

Days 1-7 following surgery or until the first follow up appointment with provider up to 14 days following surgery

Adverse event would include any report or contact with the clinic to request for additional medication refills, emergency room visit related to the surgery, any additional procedure necessary due to complications from the surgery

Some patients chose to not follow study instructions strictly and utilized ibuprofen therapy as primary analgesic treatment instead of their opioid medication.