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Does Supplemental Regional Anesthesia Decrease Length of Stay and Opioid Use for Patients Undergoing Head and Neck

Earl Peter Park¹, John Minh Le², Jordan Gigliotti³

¹Assistant Professor, Department of Oral & Maxillofacial Surgery, Louisiana State University Health Science Center, New Orleans, LA.

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons

|September 25, 2020

Summary

Regional anesthesia nerve blocks for head and neck surgery (HNS) patients significantly shorten hospital stays. While opioid use showed a trend toward reduction, it was not statistically significant, suggesting broader adoption in recovery protocols.

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Area of Science:

Surgical Anesthesiology
Head and Neck Surgery
Regional Anesthesia Techniques

Background:

Head and neck surgery (HNS) often involves complex microvascular free-flap reconstructions.
Optimizing postoperative recovery, including hospital stay and pain management, is crucial for patient outcomes.

Purpose of the Study:

To compare the length of hospital stay and opioid usage in HNS patients undergoing microvascular free-flap reconstruction with and without regional anesthesia at the donor site.

Main Methods:

A retrospective cohort study was conducted on HNS patients who underwent microvascular free-flap reconstruction.
Patients were divided into a control group (no regional anesthesia) and an experimental group (regional anesthesia nerve block before surgery).
Primary outcome was length of stay; secondary outcome was total morphine milliequivalents, analyzed using statistical tests including t-tests, ANOVA, and regression analysis.

Main Results:

The study included 148 patients (mean age 58.1 years).
The regional anesthesia group had a significantly shorter mean length of stay (5.84 days) compared to the control group (6.74 days) (P < .0001).
No statistically significant difference in mean opioid usage was observed between the groups (P = .56), despite a trend toward lower usage in the regional anesthesia group.

Conclusions:

Regional anesthesia nerve blocks at the donor site are associated with significantly shorter hospital stays for HNS patients undergoing microvascular reconstruction.
While opioid usage reduction was not statistically significant, the trend warrants further investigation.
Incorporating regional anesthesia into early recovery protocols for high-volume HNS centers is recommended.