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Multimodal analgesia after thyroid or parathyroid surgery: A randomized controlled trial.

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Area of Science:

  • Endocrinology
  • Surgery
  • Pain Management
  • Pharmacology

Background:

  • The opioid epidemic necessitates reevaluation of surgical opioid prescribing.
  • Endocrine surgery patients require effective pain management strategies.
  • This study addresses the need for optimized postoperative analgesic regimens.

Purpose of the Study:

  • To demonstrate the noninferiority of a staged analgesic regimen compared to traditional opioid-based regimens after endocrine surgery.
  • To evaluate pain scores and analgesic consumption in patients undergoing thyroidectomy and/or parathyroidectomy.

Main Methods:

  • A randomized controlled trial was conducted comparing two analgesic regimens: as-needed acetaminophen + codeine versus scheduled acetaminophen/as-needed tramadol.
  • Adult patients undergoing endocrine surgery were randomized into two study arms.
  • Pain scores and analgesic consumption were meticulously recorded by patients in study logs.

Main Results:

  • A total of 126 patients were enrolled with even randomization between arms.
  • No significant differences were observed in pain scores or total analgesic doses between the groups.
  • A statistically significant reduction in the percentage of opioid doses used was observed in the staged regimen group (27.38%) compared to the combination opioid group (79.71%).

Conclusions:

  • Patients undergoing endocrine surgery reported moderate pain with low analgesic requirements.
  • The staged analgesic regimen was found to be noninferior to combination opioid therapy.
  • This optimized regimen led to a significant reduction in overall opioid consumption.