Sarathy Ashwini, An Clemens, Bever Ty, Callas Peter, Fujii Mayo H, Sajisevi Mirabelle
Larner College of Medicine University of Vermont Burlington Vermont USA.
Department of Surgery University of Vermont Medical Center Burlington Vermont USA.
Laryngoscope Investig Otolaryngol. 2024 Mar 23;9(2):e1229. doi: 10.1002/lio2.1229. eCollection 2024 Apr.
The current study aims to measure patient-reported satisfaction with pain control using opioid and non-opioid medications after undergoing the following otolaryngology procedures: parathyroidectomy, thyroid lobectomy, total thyroidectomy, and bilateral tonsillectomy.
A prospective cohort study was performed at an academic medical center that included a telephone questionnaire and chart review. Opioid prescriptions, usage, and patient-reported pain outcomes were recorded. Bivariate analyses were used to compare opioid and non-opioid users.
Of the 107 total patients undergoing otolaryngology procedures included in the study, 49 (45.8%) used an opioid for pain management postoperatively and 58 (54.2%) did not. Among the 81 patients who underwent endocrine procedures (parathyroidectomy, total thyroidectomy/lobectomy), most patients reported being "very satisfied" or "satisfied" with pain control whether they used opioids ( = 27/30, 90%) or not ( = 50/51, 98%). Of the 26 patients who underwent bilateral tonsillectomy, 19 (73%) were prescribed opioids and among these, most ( = 17/19, 89%) reported they were "very satisfied" or "satisfied" with pain control. In the non-opioid usage group, all patients ( = 7/7, 100%) reported they were "satisfied" with pain control. There was no statistically significant difference in patient-reported satisfaction with pain control between opioid and non-opioid users for any of the procedures listed.
The results of our study suggest that patients who did not use opioids have a similar level of satisfaction with pain control compared to those using opioids after thyroid, parathyroid and tonsillectomy surgeries. Considering the magnitude of the opioid crisis, providers should reassess the need for opioid prescriptions following certain ENT procedures.
IV.
本研究旨在衡量患者在接受以下耳鼻喉科手术后使用阿片类药物和非阿片类药物控制疼痛的满意度：甲状旁腺切除术、甲状腺叶切除术、全甲状腺切除术和双侧扁桃体切除术。
在一家学术医疗中心进行了一项前瞻性队列研究，包括电话问卷调查和病历审查。记录阿片类药物处方、使用情况以及患者报告的疼痛结果。采用双变量分析比较阿片类药物使用者和非阿片类药物使用者。
在本研究纳入的107例接受耳鼻喉科手术的患者中，49例（45.8%）术后使用阿片类药物进行疼痛管理，58例（54.2%）未使用。在81例接受内分泌手术（甲状旁腺切除术、全甲状腺切除术/叶切除术）的患者中，大多数患者报告对疼痛控制“非常满意”或“满意”，无论他们是否使用阿片类药物（使用阿片类药物组：27/30，90%；未使用阿片类药物组：50/51，98%）。在26例接受双侧扁桃体切除术的患者中，19例（73%）被开具了阿片类药物处方，其中大多数（17/19，89%）报告对疼痛控制“非常满意”或“满意”。在非阿片类药物使用组中，所有患者（7/7，100%）报告对疼痛控制“满意”。对于所列的任何手术，阿片类药物使用者和非阿片类药物使用者在患者报告的疼痛控制满意度方面均无统计学显著差异。
我们的研究结果表明，在甲状腺、甲状旁腺和扁桃体切除术后，未使用阿片类药物的患者与使用阿片类药物患者的疼痛控制满意度水平相似。考虑到阿片类药物危机的严重程度，医疗服务提供者应重新评估某些耳鼻喉科手术后开具阿片类药物处方的必要性。
四级。
