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头颈部内分泌手术的围手术期疼痛管理和阿片类药物减量:美国头颈部学会内分泌外科分会共识声明。

Perioperative pain management and opioid-reduction in head and neck endocrine surgery: An American Head and Neck Society Endocrine Surgery Section consensus statement.

机构信息

Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center, San Antonio, Texas, USA.

Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.

出版信息

Head Neck. 2021 Aug;43(8):2281-2294. doi: 10.1002/hed.26774. Epub 2021 Jun 3.

Abstract

BACKGROUND

This American Head and Neck Society (AHNS) consensus statement focuses on evidence-based comprehensive pain management practices for thyroid and parathyroid surgery. Overutilization of opioids for postoperative pain management is a major contributing factor to the opioid addiction epidemic however evidence-based guidelines for pain management after routine head and neck endocrine procedures are lacking.

METHODS

An expert panel was convened from the membership of the AHNS, its Endocrine Surgical Section, and ThyCa. An extensive literature review was performed, and recommendations addressing several pain management subtopics were constructed based on best available evidence. A modified Delphi survey was then utilized to evaluate group consensus of these statements.

CONCLUSIONS

This expert consensus provides evidence-based recommendations for effective postoperative pain management following head and neck endocrine procedures with a focus on limiting unnecessary use of opioid analgesics.

摘要

背景

本美国头颈部协会(AHNS)共识声明侧重于甲状腺和甲状旁腺手术的基于证据的综合疼痛管理实践。然而,术后疼痛管理中阿片类药物的过度使用是阿片类药物成瘾流行的一个主要因素,但常规头颈部内分泌手术术后疼痛管理的循证指南却缺乏。

方法

从 AHNS、其内分泌外科分会和 ThyCa 的成员中召集了一个专家小组。进行了广泛的文献回顾,并根据最佳现有证据构建了针对几个疼痛管理子主题的建议。然后使用改良 Delphi 调查来评估对这些声明的小组共识。

结论

本专家共识为头颈部内分泌手术后的有效术后疼痛管理提供了基于证据的建议,重点是限制不必要的阿片类镇痛药的使用。

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