Randomized control trial of opioid- versus nonopioid-based analgesia after thyroidectomy.
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: 2020Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:- 0039-6060
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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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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