Preoperative Acetaminophen For Microsuspension Laryngoscopy Reduces Postoperative Opioid Use.

microlaryngoscopy microsuspension laryngoscopy narcotic analgesics opioids postoperative pain

Journal

The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378

Informations de publication

Date de publication:
05 Jul 2024
Historique:
revised: 30 05 2024
received: 10 03 2024
accepted: 03 06 2024
medline: 5 7 2024
pubmed: 5 7 2024
entrez: 5 7 2024
Statut: aheadofprint

Résumé

The opioid crisis has prompted consideration of analgesic prescriptions. This study explored the value of preoperative acetaminophen for pain control following microsuspension laryngoscopy (MSL) and compared the results with a previous study of pain and opioid use following MSL (Tsang et al.). A prospective open-label clinical trial was conducted in patients undergoing MSL. All patients were administered preoperative acetaminophen. Short-form McGill Pain Questionnaire (SF-MPQ), pain visual analogue scale (VAS), and present pain intensity (PPI) scores were collected preoperatively and on postoperative days (PODs) 1, 3, 7, and 14. Statistical analysis identified variables associated with opioid use or increased pain scores, and compared outcomes with Tsang et al. RESULTS: Eighty-nine patients were included (mean age 52.8 ± 17.3 years, 40 males). All patients received preoperative 1 g acetaminophen (77 (86.5%) orally) with no adverse effects. On POD1, opioid usage was 10%. Median [IQR] pain scores were 5 [2-11], 21 [12.3-56.8], and 3 [2-3.3] on SF-MPQ, VAS, and PPI, respectively. Post-Anesthesia Care Unit (PACU) opioid requirements significantly correlated with POD1 opioid consumption (τb = 0.214; p ≤ 0.05), and significant associations with PACU opioid administration were found for total anesthesia time (OR (95%CI) = 1.271 (1.043-1.548), p = 0.017) and total laryngoscope suspension time (OR (95%CI) = 0.791 (0.651-0.962, p = 0.019)). This cohort demonstrated reduced opioid usage on POD1 compared with Tsang et al (23%). Preoperative acetaminophen is a safe intervention, resulting in decreased postoperative opioid use following MSL. Anesthesia time correlated with need for postoperative opioids. Level 4 Laryngoscope, 2024.

Identifiants

pubmed: 38967426
doi: 10.1002/lary.31610
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The American Laryngological, Rhinological and Otological Society, Inc.

Références

Fiore JF Jr, El‐Kefraoui C, Chay MA, et al. Opioid versus opioid‐free analgesia after surgical discharge: a systematic review and meta‐analysis of randomised trials. Lancet. 2022;399(10343):2280‐2293. https://doi.org/10.1016/S0140-6736(22)00582-7
Huston MN, Kamizi R, Meyer TK, Merati AL, Giliberto JP. Current opioid prescribing patterns after microdirect laryngoscopy. Ann Otol Rhinol Laryngol. 2020;129(2):142‐148. https://doi.org/10.1177/0003489419877912
Anne S, Mims JW, Tunkel DE, et al. Clinical practice guideline: opioid prescribing for analgesia after common otolaryngology operations executive summary. Otolaryngol Head Neck Surg. 2021;164(4):687‐703. https://doi.org/10.1177/0194599821996303
Tsang TM, Brett O, Hu A. Patient perception and duration of pain after microdirect laryngoscopy. Otolaryngol Head Neck Surg. 2020;162(5):702‐708. https://doi.org/10.1177/0194599820907904
Bisarya PK, Jiang R, Chao J, Narwani V, Lerner M, Kohli N. Adequate short‐ and long‐term pain control with non‐opiate analgesics after microdirect laryngoscopy. Am J Otolaryngol. 2022;43(1):103267. https://doi.org/10.1016/j.amjoto.2021.103267
Taliercio S, Sanders B, Achlatis S, Fang Y, Branski R, Amin M. Factors associated with the use of postoperative analgesics in patients undergoing direct microlaryngoscopy. Ann Otol Rhinol Laryngol. 2017;126(5):375‐381. https://doi.org/10.1177/0003489417693862
Balouch B, Vontela S, Ranjbar PA, Alnouri G, Sataloff RT. Assessment of postoperative pain and opioid consumption following laryngeal surgery: a pilot study. J Voice. 2024;38(2):516‐520. https://doi.org/10.1016/j.jvoice.2021.08.024
Moller PL, Sindet‐Pedersen S, Petersen CT, Juhl GI, Dillenschneider A, Skoglund LA. Onset of acetaminophen analgesia: comparison of oral and intravenous routes after third molar surgery. Br J Anaesth. 2005;94(5):642‐648. https://doi.org/10.1093/bja/aei109
Doleman B, Read D, Lund JN, Williams JP. Preventive acetaminophen Reduces postoperative opioid consumption, vomiting, and pain scores after surgery: systematic review and meta‐analysis. Reg Anesth Pain Med. 2015;40(6):706‐712. https://doi.org/10.1097/AAP.0000000000000311
De Oliveira GS Jr, Castro‐Alves LJ, McCarthy RJ. Single‐dose systemic acetaminophen to prevent postoperative pain: a meta‐analysis of randomized controlled trials. Clin J Pain. 2015;31(1):86‐93. https://doi.org/10.1097/AJP.0000000000000081
Koteswara CM, Sheetal D. A study on pre‐Emptive analgesic effect of intravenous paracetamol in functional endoscopic sinus surgeries (FESSs): a randomized, double‐blinded clinical study. J Clin Diagn Res. 2014;8(1):108‐111. https://doi.org/10.7860/JCDR/2014/7016.3922
Bhoja R, Ryan MW, Klein K, et al. Intravenous vs oral acetaminophen in sinus surgery: a randomized clinical trial. Laryngoscope Investig Otolaryngol. 2020;5(3):348‐353. https://doi.org/10.1002/lio2.375
Melzack R. The short‐form McGill pain questionnaire. Pain. 1987;30(2):191‐197. https://doi.org/10.1016/0304-3959(87)91074-8
Velez JC, Friedman LE, Barbosa C, et al. Evaluating the performance of the pain interference index and the short form McGill pain questionnaire among Chilean injured working adults. PLoS One. 2022;17(5):e0268672. https://doi.org/10.1371/journal.pone.0268672
Lázaro C, Caseras X, Whizar‐Lugo VM, et al. Psychometric properties of a Spanish version of the McGill pain questionnaire in several Spanish‐speaking countries. Clin J Pain. 2001;17(4):365‐374. https://doi.org/10.1097/00002508-200112000-00012
Lázaro C, Bosch F, Torrubia R, Baños JE. The development of a Spanish questionnaire for assessing pain: preliminary data concerning reliability and validity. Eur J Psychol Assess. 1994;10(2):145‐151. https://psycnet.apa.org/fulltext/1995-11922-001.pdf
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata‐driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377‐381. https://doi.org/10.1016/j.jbi.2008.08.010
Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208. https://doi.org/10.1016/j.jbi.2019.103208
Myles PS, Myles DB, Galagher W, et al. Measuring acute postoperative pain using the visual analog scale: the minimal clinically important difference and patient acceptable symptom state. Br J Anaesth. 2017;118(3):424‐429. https://doi.org/10.1093/bja/aew466
Grafton KV, Foster NE, Wright CC. Test‐retest reliability of the short‐form McGill pain questionnaire: assessment of intraclass correlation coefficients and limits of agreement in patients with osteoarthritis. Clin J Pain. 2005;21(1):73‐82. https://doi.org/10.1097/00002508-200501000-00009
Strand LI, Ljunggren AE, Bogen B, Ask T, Johnsen TB. The short‐form McGill pain questionnaire as an outcome measure: test‐retest reliability and responsiveness to change. Eur J Pain. 2008;12(7):917‐925. https://doi.org/10.1016/j.ejpain.2007.12.013
Biskup M, Dzioba A, Sowerby LJ, Monteiro E, Strychowsky J. Opioid prescribing practices following elective surgery in Otolaryngology‐Head & Neck Surgery. J Otolaryngol Head Neck Surg. 2019;48(1):29. https://doi.org/10.1186/s40463-019-0352-9
Phillips DM. JCAHO pain management standards are unveiled. Joint commission on accreditation of healthcare organizations. Jama. 2000;284(4):428‐429. https://doi.org/10.1001/jama.284.4.423b
Gordon DB, Dahl JL, Miaskowski C, et al. American pain society recommendations for improving the quality of acute and cancer pain management: American pain society quality of care task force. Arch Intern Med. 2005;165(14):1574‐1580. https://doi.org/10.1001/archinte.165.14.1574
Gerbershagen HJ, Rothaug J, Kalkman CJ, Meissner W. Determination of moderate‐to‐severe postoperative pain on the numeric rating scale: a cut‐off point analysis applying four different methods. Br J Anaesth. 2011;107(4):619‐626. https://doi.org/10.1093/bja/aer195
Quality improvement guidelines for the treatment of acute pain and cancer pain. American pain society quality of care committee. Jama. 1995;274(23):1874‐1880. https://doi.org/10.1001/jama.1995.03530230060032
McNicol ED, Tzortzopoulou A, Cepeda MS, Francia MBD, Farhat T, Schumann R. Single‐dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: a systematic review and meta‐analysis. Br J Anaesth. 2011;106(6):764‐775. https://doi.org/10.1093/bja/aer107
Xuan C, Yan W, Wang D, Mueller A, Ma H, Wang J. Effect of preemptive acetaminophen on opioid consumption: a meta‐analysis. Pain Physician. 2021;24(2):E153‐E160. https://www.ncbi.nlm.nih.gov/pubmed/33740343
Pelzer D, Burgess E, Cox J, Baker R. Preoperative intravenous versus Oral acetaminophen in outpatient surgery: a double‐blinded, randomized control trial. J Perianesth Nurs. 2021;36(2):162‐166. https://doi.org/10.1016/j.jopan.2020.07.010
Hickman SR, Mathieson KM, Bradford LM, Garman CD, Gregg RW, Lukens DW. Randomized trial of oral versus intravenous acetaminophen for postoperative pain control. Am J Health Syst Pharm. 2018;75(6):367‐375. https://doi.org/10.2146/ajhp170064
Politi JR, Davis RL 2nd, Matrka AK. Randomized prospective trial comparing the use of intravenous versus Oral acetaminophen in Total joint arthroplasty. J Arthroplasty. 2017;32(4):1125‐1127. https://doi.org/10.1016/j.arth.2016.10.018
Cain KE, Iniesta MD, Fellman BM, et al. Effect of preoperative intravenous vs oral acetaminophen on postoperative opioid consumption in an enhanced recovery after surgery (ERAS) program in patients undergoing open gynecologic oncology surgery. Gynecol Oncol. 2021;160(2):464‐468. https://doi.org/10.1016/j.ygyno.2020.11.024
Singh AM, Kirsch JM, Patel MS, et al. Effect of perioperative acetaminophen on pain management in patients undergoing rotator cuff repair: a prospective randomized study. J Shoulder Elbow Surg. 2021;30(9):2014‐2021. https://doi.org/10.1016/j.jse.2021.03.132
Moon YE, Lee YK, Lee J, Moon DE. The effects of preoperative intravenous acetaminophen in patients undergoing abdominal hysterectomy. Arch Gynecol Obstet. 2011;284(6):1455‐1460. https://doi.org/10.1007/s00404-011-1860-7
Fang R, Chen H, Sun J. Analysis of pressure applied during microlaryngoscopy. Eur Arch Otorhinolaryngol. 2012;269(5):1471‐1476. https://doi.org/10.1007/s00405-012-1929-3
Feng AL, Ciaramella A, Naunheim MR, Gadkaree SK, Fat I, Song PC. Laryngeal force sensor metrics are predictive of increased perioperative narcotic requirements. Laryngoscope. 2019;129(11):2563‐2567. https://doi.org/10.1002/lary.27827
Rudikoff AG, Tieu DD, Banzali FM, et al. Perioperative acetaminophen and dexmedetomidine eliminate post‐operative opioid requirement following pediatric tonsillectomy. J Clin Med Res. 2022;11(3):561. https://doi.org/10.3390/jcm11030561

Auteurs

Antonia Lagos-Villaseca (A)

Department of Otolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile.

James J Lappin (JJ)

UCSF Voice and Swallowing Center, Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.

Claire E Perrin (CE)

UCSF Voice and Swallowing Center, Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.

Yue Ma (Y)

UCSF Voice and Swallowing Center, Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.

VyVy N Young (VN)

UCSF Voice and Swallowing Center, Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.

George W Pasvankas (GW)

Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, U.S.A.

Steven D Stockton (SD)

Stockton Scientific Services, Glastonbury, Connecticut, U.S.A.

Clark A Rosen (CA)

UCSF Voice and Swallowing Center, Department of Otolaryngology-Head & Neck Surgery, University of California San Francisco, San Francisco, California, U.S.A.

Chanticha Laohakittikul (C)

Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Classifications MeSH