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Randomized control trial of opioid- versus nonopioid-based analgesia after thyroidectomy.

MedStar author(s):

Felger, Erin A

Handy, Kevin G

Citation: Surgery. 167(6):957-961, 2020 Jun.PMID: 32127178Institution: MedStar Washington Hospital CenterDepartment: Anesthesiology | Medicine/Endocrinology | Surgery/Endocrine Surgery | Surgery/General SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Analgesics, Non-Narcotic/tu [Therapeutic Use] | *Analgesics, Opioid/tu [Therapeutic Use] | *Pain, Postoperative/dt [Drug Therapy] | *Thyroidectomy | Acetaminophen/tu [Therapeutic Use] | Female | Humans | Ibuprofen/tu [Therapeutic Use] | Male | Middle Aged | Oxycodone/tu [Therapeutic Use] | Visual Analog ScaleYear: 2020 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:

0039-6060

Name of journal: SurgeryAbstract: BACKGROUND: Opioid-based analgesia is the most common method for pain control in the postoperative period. Limited data exist to compare the adequacy of pain control in the post thyroidectomy period with nonopioid-based analgesia. We aimed to evaluate the efficacy of nonopioid-based, postoperative analgesia.CONCLUSION: In a randomized control trial, we showed that patients treated with nonopioid analgesia had similar pain scores to those treated with opioids, with the benefit of having lower opioid exposure in the perioperative period. Copyright (c) 2020 Elsevier Inc. All rights reserved.METHODS: After institutional review board approval, patients were randomized to 1 of 2 pain control regimens. Sample size was calculated to assess for a pain score difference of 1 based on a visual analog scale. The control group received opioid-based, postoperative analgesia, whereas the study group received nonopioid-based analgesia of acetaminophen and ibuprofen. Pain scores (measured on visual analog scale) and opioid use (converted to morphine equivalent dose) were measured after completion of the operation.RESULTS: The sample sizes for the study and control groups were 49 and 46 patients, respectively. The pain score for the study and control groups 1 hour after the operation (3.3 vs 3.9, P = .35), 6 hours after the operation (2.8 vs 3.0, P = .08), on postoperative day 1 (1.6 vs 2.4, P = .08) and on the first office visit (0.2 vs 0.1, P = .82) did not have a statistically significant difference. Morphine equivalent opioid requirement for pain control in the postoperative period was 0.8 vs 6.9 mg (P < .01), respectively.All authors: Felger EA, Handy KG, Hassanein MT, Nosanov LS, Papoian V, Tolentino RA, Villano AMOriginally published: Surgery. 167(6):957-961, 2020 Jun.Fiscal year: FY2020Digital Object Identifier:

https://dx.doi.org/10.1016/j.surg.2020.01.011

Date added to catalog: 2020-07-09

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	32127178	Available		32127178

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

BACKGROUND: Opioid-based analgesia is the most common method for pain control in the postoperative period. Limited data exist to compare the adequacy of pain control in the post thyroidectomy period with nonopioid-based analgesia. We aimed to evaluate the efficacy of nonopioid-based, postoperative analgesia.

CONCLUSION: In a randomized control trial, we showed that patients treated with nonopioid analgesia had similar pain scores to those treated with opioids, with the benefit of having lower opioid exposure in the perioperative period. Copyright (c) 2020 Elsevier Inc. All rights reserved.

METHODS: After institutional review board approval, patients were randomized to 1 of 2 pain control regimens. Sample size was calculated to assess for a pain score difference of 1 based on a visual analog scale. The control group received opioid-based, postoperative analgesia, whereas the study group received nonopioid-based analgesia of acetaminophen and ibuprofen. Pain scores (measured on visual analog scale) and opioid use (converted to morphine equivalent dose) were measured after completion of the operation.

RESULTS: The sample sizes for the study and control groups were 49 and 46 patients, respectively. The pain score for the study and control groups 1 hour after the operation (3.3 vs 3.9, P = .35), 6 hours after the operation (2.8 vs 3.0, P = .08), on postoperative day 1 (1.6 vs 2.4, P = .08) and on the first office visit (0.2 vs 0.1, P = .82) did not have a statistically significant difference. Morphine equivalent opioid requirement for pain control in the postoperative period was 0.8 vs 6.9 mg (P < .01), respectively.

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