[Prevention and relief of pain induced by otolaryngology procedures]

There are many types of pain induced in otolaryngology, stemming from medical acts, sinus drainage, packing of the nasal fossae, or complex bandaging after cancer surgery. In patients with impaired communication abilities resulting from impaired speech, greater attention must be paid to induced pain, sometimes requiring the use of behavioral evaluation scales. Preventing this pain means organizing medical acts and painful treatments by attempting to group them and informing the patient that the caregiver is listening to him and relieving his pain. Non-drug treatments should always be attempted, are based on a trusting relationship with the patient, a comfortable position, diverting his attention, and using bandaging that is less painful when removed. However, use of drug treatments often remains indispensable. The strong morphinics are used most often despite a pharmacokinetic profile that is poorly adapted and the undesirable side effects in case of repeated administration. Local anesthetics should be used whenever possible. Dissemination of nursing protocols for the use of MEOPA provides good pain relief providing that there are trained personnel in sufficient numbers. The intensity of pain induced by certain medical acts requires use of brief general anesthesia, which can often be done in the ambulatory situation and is preferable to deep sedation outside of the safety of the operating room.