A retrospective analysis of pain and opioid usage in head and neck free flap reconstruction.

MedStar author(s):
Citation: World Journal Of Otorhinolaryngology - Head And Neck Surgery. 9(2):153-159, 2023 Jun.PMID: 37383327Institution: MedStar Washington Hospital CenterDepartment: MedStar Georgetown University Hospital/MedStar Washington Hospital Center | Otolaryngology | Otolaryngology ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: Year: 2023ISSN:
  • 2095-8811
Name of journal: World journal of otorhinolaryngology - head and neck surgeryAbstract: Conclusions: For patients undergoing head and neck free flap operations, opioid medications are commonly used for postoperative analgesia. This practice may increase the chance an opioid-naive patient uses opioids chronically. We found a poor association between MEDs administered and patient-reported pain scores, which suggests that standardized protocols aimed at optimizing analgesia while reducing opioid administration may be warranted. Level of Evidence: 3 (Retrospective cohort study). Copyright © 2023 The Authors. World Journal of Otorhinolaryngology - Head and Neck Surgery published by John Wiley & Sons Ltd on behalf of Chinese Medical Association.Methods: A retrospective review of 100 consecutive patients undergoing head and neck free flap reconstruction at two academic centers was performed. Data captured included demographics, postoperative inpatient pain, pain at postoperative visits, morphine equivalent doses (MEDs) administration, medication history, and comorbidities. Data were analyzed using regression models, chi 2 tests, and student's t-tests.Objectives: Investigate opioid usage and postoperative pain in patients undergoing head and neck free flap surgery.Results: Seventy-three percent of patients were discharged with opioid medication, with over half (53.4%) continuing to take opioids at their second postoperative visit, and over one-third (34.2%) continuing to take them around 4-month postoperatively. One out of every five (20.3%) opioid-naive patients chronically took opioids postoperatively. There was a poor association between inpatient postoperative pain scores and daily MEDs administered (R 2 = 0.13, 0.17, and 0.22 in postoperative Days 3, 5, and 7, respectively). Neither preoperative radiotherapy nor postoperative complications were associated with an increase in opioid usage.All authors: Crossley JR, Giurintano JP, Hill A, Leonard JA, Pierce ML, Reilly MJ, Towfighi P, Walsh AFiscal year: FY2023Digital Object Identifier: Date added to catalog: 2023-07-21
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Journal Article MedStar Authors Catalog Article 37383327 Available 37383327

Conclusions: For patients undergoing head and neck free flap operations, opioid medications are commonly used for postoperative analgesia. This practice may increase the chance an opioid-naive patient uses opioids chronically. We found a poor association between MEDs administered and patient-reported pain scores, which suggests that standardized protocols aimed at optimizing analgesia while reducing opioid administration may be warranted. Level of Evidence: 3 (Retrospective cohort study). Copyright © 2023 The Authors. World Journal of Otorhinolaryngology - Head and Neck Surgery published by John Wiley & Sons Ltd on behalf of Chinese Medical Association.

Methods: A retrospective review of 100 consecutive patients undergoing head and neck free flap reconstruction at two academic centers was performed. Data captured included demographics, postoperative inpatient pain, pain at postoperative visits, morphine equivalent doses (MEDs) administration, medication history, and comorbidities. Data were analyzed using regression models, chi 2 tests, and student's t-tests.

Objectives: Investigate opioid usage and postoperative pain in patients undergoing head and neck free flap surgery.

Results: Seventy-three percent of patients were discharged with opioid medication, with over half (53.4%) continuing to take opioids at their second postoperative visit, and over one-third (34.2%) continuing to take them around 4-month postoperatively. One out of every five (20.3%) opioid-naive patients chronically took opioids postoperatively. There was a poor association between inpatient postoperative pain scores and daily MEDs administered (R 2 = 0.13, 0.17, and 0.22 in postoperative Days 3, 5, and 7, respectively). Neither preoperative radiotherapy nor postoperative complications were associated with an increase in opioid usage.

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