Department of Otolaryngology, University of Kentucky College of Medicine, Lexington, KY, USA.
Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA.
Am Surg. 2023 Apr;89(4):942-947. doi: 10.1177/00031348211048846. Epub 2021 Nov 3.
The aim of this study was to evaluate pain control and patient satisfaction using an opioid-free analgesic regimen following thyroid and parathyroid operations.
Surveys were distributed to all postoperative patients following total thyroidectomy, thyroid lobectomy, and parathyroidectomy between January and April 2020. After surgery, patients were discharged without opioids except in rare cases based on patient needs and surgeon judgment. We measured patient-reported Numeric Rating Scale (NRS) pain scores and satisfaction categorically as either satisfied or dissatisfied.
We received 90 of 198 surveys distributed, for a 45.5% response rate. After excluding neck dissections (n = 6) and preoperative opioid use (n = 4), the final cohort included 80 patients after total thyroidectomy (26.3%), thyroid lobectomy (41.3%), and parathyroidectomy (32.5%).The majority reported satisfaction with pain control (87.5%) and the entire surgical experience (95%). A similar proportion of patients reported satisfaction with pain control after total thyroidectomy (90.9%), thyroid lobectomy (90.5%), and parathyroidectomy (80.8%), indicating the procedure did not significantly impact satisfaction with pain control ( = .47). Patients who reported dissatisfaction with pain control were more likely to receive opioid prescriptions (30% vs 2.9%, < .01), but the majority still reported satisfaction with their entire operative experience (70%).
Even with an opioid-free postoperative pain regimen, most patients report satisfaction with pain control after thyroid and parathyroid operations, and those who were dissatisfied with their pain control generally reported satisfaction with their overall surgical experience. Therefore, an opioid-free postoperative pain control regimen is well tolerated and unlikely to decrease overall patient satisfaction.
本研究旨在评估甲状腺和甲状旁腺手术后使用无阿片类药物的镇痛方案的疼痛控制和患者满意度。
在 2020 年 1 月至 4 月期间，我们向所有接受甲状腺全切除术、甲状腺叶切除术和甲状旁腺切除术的术后患者分发了调查。手术后，除非根据患者的需求和外科医生的判断，否则患者在罕见情况下不会开阿片类药物。我们通过患者报告的数字评分量表（NRS）疼痛评分和满意度（满意或不满意）对患者进行分类。
我们共收到 198 份调查中的 90 份，应答率为 45.5%。排除颈部清扫术（n=6）和术前使用阿片类药物（n=4）后，最终队列包括 80 例甲状腺全切除术（26.3%）、甲状腺叶切除术（41.3%）和甲状旁腺切除术（32.5%）患者。大多数患者报告对疼痛控制（87.5%）和整个手术体验（95%）满意。接受甲状腺全切除术（90.9%）、甲状腺叶切除术（90.5%）和甲状旁腺切除术（80.8%）的患者对疼痛控制的满意度相似，这表明手术并未显著影响患者对疼痛控制的满意度（ =.47）。报告对疼痛控制不满意的患者更有可能接受阿片类药物处方（30% vs 2.9%， <.01），但大多数患者仍对他们的整个手术体验表示满意（70%）。
即使采用无阿片类药物的术后疼痛管理方案，大多数患者在甲状腺和甲状旁腺手术后仍报告对疼痛控制满意，而对疼痛控制不满意的患者通常对整体手术体验表示满意。因此，无阿片类药物的术后疼痛控制方案可被良好耐受，不太可能降低整体患者满意度。
