Multimodal Analgesia Protocol after Head and Neck Surgery: Effect on Opioid Use and Pain Control

Area of Science:

• Anesthesiology and Pain Management
• Surgical Oncology
• Quality Improvement Initiatives

Background:

• Head and neck (H&N) surgery patients often require significant postoperative analgesia.
• Optimizing pain control while minimizing opioid use is a critical challenge in H&N surgery recovery.
• Multimodal analgesic strategies aim to improve pain management and reduce opioid dependence.

Purpose of the Study:

• To evaluate the impact of implementing a multimodal analgesic protocol on opioid requirements in H&N surgery patients.
• To assess the effect of this protocol on postoperative pain control.
• To determine the feasibility of opioid-sparing analgesia in the H&N surgical population.

Main Methods:

• A prospective cohort study was conducted at a tertiary academic hospital.
• Data were collected from electronic health records and patient surveys before and after protocol implementation.
• Morphine milligram equivalents (MMEs) and average pain scores were compared between preprotocol and postprotocol groups.

Main Results:

• The study compared 139 postprotocol patients to 89 preprotocol patients.
• Adjusted MMEs in the first 24 hours significantly decreased from 93.7 mg to 58.6 mg (P = .026) post-implementation.
• Average pain scores immediately after surgery and on discharge did not significantly change.

Conclusions:

• Implementation of a multimodal analgesia plan effectively reduced immediate postoperative opioid use in H&N surgery patients.
• The protocol did not lead to statistically significant reductions in opioid use over the entire hospital stay or improve pain scores.
• Multimodal opioid-sparing analgesia is feasible for H&N surgery, warranting further research into optimal strategies.