Patient-Reported Pain and Opioid Use After Ambulatory Head and Neck Surgery

Area of Science:

• Head and Neck Surgery
• Pain Management
• Surgical Oncology

Background:

• Postoperative pain and opioid use are significant concerns following head and neck procedures.
• Quantifying these factors after hemithyroidectomy and cervical lymph node biopsy (CLNB) is crucial for optimizing patient care.
• Understanding factors influencing pain and opioid consumption can guide analgesic strategies.

Purpose of the Study:

• To quantify daily pain and opioid consumption in patients after hemithyroidectomy and CLNB.
• To identify factors associated with reduced pain and opioid requirements in the postoperative period.

Main Methods:

• A prospective cohort study was conducted from June 2017 to February 2019.
• Adult patients undergoing hemithyroidectomy and CLNB completed daily surveys for 2 weeks, recording pain (visual analog scale) and opioid use (morphine milligram equivalents).
• Data from 29 patients were analyzed.

Main Results:

• Pain resolved within 2 weeks for both procedures.
• Cervical lymph node biopsy (CLNB) patients used a median of 15.0 MME; 95% used ≤70 MME.
• Hemithyroidectomy patients used a median of 8.2 MME; 95% used ≤30 MME.
• Nonopioid analgesic use correlated with significantly lower pain and opioid use in CLNB patients, but not in hemithyroidectomy patients.

Conclusions:

• Patients exhibit low pain and opioid requirements following hemithyroidectomy and CLNB.
• Head and neck surgeons can consider reducing postoperative opioid prescriptions.
• The findings support the judicious use of nonopioid analgesics to manage pain and opioid consumption.