Anticipated absence from work ('sick leave') following routine ENT surgery: are we giving the correct advice? A postal questionnaire survey

Abstract

In the UK patients who undergo common ear, nose and throat (ENT) operations, and are employed, are advised to take 2 weeks sick leave before returning to their employment. A retrospective postal questionnaire survey (of adult patients who had undergone four common specific ENT operations) was conducted, to validate whether this preoperative advice given, was appropriate, and to attempt to assess the patient factors, which influenced the amount of postoperative absence from work. Among 218 questionnaires sent, 156 (71.6%) responses were returned and 132 (60.6%) were used. Analysis of the data for absence from work, showed that 58.3% had taken <or= 2 weeks and 41.7% had taken > 2 weeks. The majority of patients (70.5%) stated that 2 weeks absence following their surgery was appropriate, whereas 5.3% reported that the period was excessive and 24.2% felt that it was inadequate. Postoperative pain (30.3%), infection (30.3%), bleeding (7.6%) and other causes (15.2%) were reported as the reasons for the delay to return to work. Nearly 31% of men and 55% of women had taken > 2 weeks of sick leave. In conclusion, the current practice of advising employed adults to take 2 weeks time off work following routine ENT surgery is appropriate. However, nearly 42% had taken > 2 weeks to return to their employment. Patients who underwent tonsillectomy and laser palatoplasty in general, required more time to recuperate prior to returning to work, when compared to those who had undergone septoplasty and functional endoscopic sinus surgery (FESS). Postoperative pain and infection were reported to be the main reasons for the delay in returning to work. Men, and self-employed patients returned to work earlier than women and other employed groups.

The effectiveness of preemptive sphenopalatine ganglion block on postoperative pain and functional outcomes after functional endoscopic sinus surgery

“…2,5,6 Inappropriate management of pain frequently contributes to patient dissatisfaction with the procedure and may delay a return to work for up to 2 weeks or longer. 2,19 Prior studies have several limitations: (1) they lack information about adequate inclusion and exclusion criteria (eg, patients with preexisting chronic facial pain, chronic pain syndromes of different etiology, or those using analgesics or antidepressant medications on a regular basis); (2) patient stratification is absent (bilateral vs unilateral, general vs local anesthesia or monitored anesthesia care); (3) standardized intraoperative and postoperative anesthetic protocols are absent (likely resulting in patients receiving different amounts of opioid analgesics); or (4) documentation is poor regarding use of local infiltrative anesthesia or nerve blocks intraoperatively by the surgeon.…”

Pain Treatment and Recovery After Endoscopic Sinus Surgery

“…However, it is clear that effective pain management is important for several reasons. First, pain is the most important cause for delayed return to normal daily activities and work after routine ENT surgery 4 . Second, postoperative pain is an important cause for readmission after day‐case nasal surgery 5 .…”

Stakeholders’ views of recurrent sore throat, tonsillitis and their management: a qualitative interview study for the NAtional Trial of Tonsillectomy IN Adults (NATTINA Part 1)

“…Decision‐making for recurrent sore throats is mostly undertaken in primary care where there is greatest potential for evolution in the patient pathway. Tonsillectomy is a painful procedure requiring two weeks off work . UK primary care now restricts referrals for treatments they deem to be of limited clinical value with tonsillectomy ranked top as a ‘relatively ineffective’ procedure .…”