Characterization of pain after tympanoplasty and tympanomastoidectomy and analysis of risk factors. A prospective cohort study

Neiderman, Narin N. Carmel; Frisch, M.; Handzel, Ophir; Ungar, Omer J.; Oron, Yahav; Cavel, Oren

doi:10.1007/s00405-021-06845-y

Cited by 2 publications

(7 citation statements)

References 10 publications

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“…A study by Neiderman et al, evaluated the postoperative pain after tympano-mastoidectomy. Similar to our study, they showed that the mean pain in the control group was higher than the block group at all times, and the mean maximum pain recorded during recovery was 3.7±1.4 (11). Our study showed that the mean pain at all times according to the numerical ratio scale (NRS) in the control group was statistically significantly higher than in the treatment group.…”

Section: Discussionsupporting

confidence: 89%

Effect of Ultrasound-Guided Superficial Cervical Plexus Block on Severity of Pain After Tympano-Mastoidectomy

Yazdi¹,

Pestehei²,

Sanatkar³

2022

ACTA

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Postoperative pain is one of the most important factors in the recovery process after surgery. The incision site of tympano-mastoidectomy is related to the innervation of the superficial cervical plexus. The aim of this study is to evaluate the effect of superficial cervical plexus block on reducing post-tympano-mastoidectomy pain. This is a prospective, double-blind clinical trial study, and patients aged 20-61 years who were candidates for tympano-mastoidectomy were included in the study and were randomly divided into two groups. Before induction of general anesthesia, the subjects underwent superficial cervical plexus block with ultrasound guidance, injection of ropivacaine 0.2% in the treatment group, and normal saline in the control group, respectively. Hemodynamic parameters, intraoperative remifentanil used to maintain hemodynamic stability, the severity of perioperative pain, nausea and vomiting, and perioperative analgesic use were compared between the two groups. Pain intensity in the recovery phase, 2, 6, 12, and 24 hours after surgery in the treatment was 2.6, 1.8, 1.4, 0.5, and 0.4 and in the control, group was 3.7, 2.5, 2.1, 1.5, and 0.9, respectively (P<0.05). Intraoperative use of remifentanil was 410±622.2 µg in the block group and 1340±448.4 µg in the control group, respectively. The need for opioid administration was 8.2±10.4 mg in the block group and 13±13.2 mg in the control group, respectively (P=0.046). The need for administration of diclofenac in the first 24 hours after surgery was 8±27.4 mg in the treatment group and 54±50 mg in the control group, respectively (P<0.001). Superficial cervical plexus block can significantly reduce pain and the need for opioid administration after the tympano-mastoidectomy operation.

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Section: Discussionsupporting

confidence: 89%

Effect of Ultrasound-Guided Superficial Cervical Plexus Block on Severity of Pain After Tympano-Mastoidectomy

Yazdi¹,

Pestehei²,

Sanatkar³

2022

ACTA

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“…This prospective cohort study of adult patients undergoing elective tympanoplasty with or without mastoidectomy in a tertiary referral center was conducted between July 2018 and July 2019. After providing informed consent, the patients filled in otology (OQ) and State-Trait Personality Inventory (STPI) questionnaires (5) (CD Spielberger, et al unpublished data). Both questionnaires were filled in preoperatively (baseline), and the OQ was also filled in on postoperative days (PODs) 1, 2, 3, 4, 21, and 49.…”

Section: Methodsmentioning

confidence: 99%

“…This OQ was developed in 2017 by Carmel Neiderman et al (5) to assess not only the intensity of pain but also various aspects of it, such as operated ear sensitivity to touch, the relation of pain to mastication, the influence of pain on sleep, and the use of drugs for pain alleviation. The questionnaire also includes questions on tinnitus, migraine headache, and pain in other parts of the body.…”

Section: Methodsmentioning

confidence: 99%

“…A recent study identified several predictors of heightened postoperative pain, none of which could be controlled (age, revision surgery, etc.) (5). Interestingly, accompanying surgery-related symptoms, such as dizziness and tinnitus, were also reported to negatively affect the perception of postoperative pain (5).…”

Section: Introductionmentioning

confidence: 99%

“…(5). Interestingly, accompanying surgery-related symptoms, such as dizziness and tinnitus, were also reported to negatively affect the perception of postoperative pain (5).…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Anxiety Levels and Postoperative Middle Ear Surgery Pain Levels

et al. 2023

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ObjectiveThis study aimed to characterize self-reported postoperative pain after tympanoplasty and tympanomastoidectomy and correlate pain severity with the patient's preoperative anxiety state.Study DesignProspective cohort study.SettingTertiary referral medical center.PatientsAdult patients undergoing any middle ear surgery between July 2018 and July 2019.Main Outcome MeasuresPatient responses to an otology questionnaire (OQ) for scoring pain intensity on a visual analog scale preoperatively and on postoperative days (PODs) 1–4, 21, and 63. The responses were correlated with anxiety state (assessed by State-Trait Personality Inventory [STPI] scores) and clinical and operative data, including surgical technique–related details.ResultsSixty patients were enrolled (mean age ± standard deviation, 40 ± 19.7 yr, 26 men). Their median preoperative (baseline) visual analog scale pain score was 6 on POD1, 5 on POD3, and 1 at 3 and 7 weeks. Their median preoperative OQ score was 32 of 70 (45.7%), 37 of 70 (52.8%) on POD1, 33 of 70 (47.1%) on POD3, 6 of 70 (8.5%) at 3 weeks, and 6 of 70 at 7 weeks. Their overall mean preoperative anxiety level (STPI score) was 2.63 ± 1.50. STPI scores were significantly higher among patients who reported OQ scores equal to or higher than the median during PODs 1 to 4 in comparison to patients who reported OQ scores lower than the median. The α Cronbach correlation between anxiety and postoperative pain scores on POD1 was 0.97.ConclusionPreoperative anxiety levels are closely associated with postoperative pain levels after any middle ear surgery. Measures to control preoperative anxiety are warranted to alleviate postoperative pain.

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Characterization of pain after tympanoplasty and tympanomastoidectomy and analysis of risk factors. A prospective cohort study

Cited by 2 publications

References 10 publications

Effect of Ultrasound-Guided Superficial Cervical Plexus Block on Severity of Pain After Tympano-Mastoidectomy

Effect of Ultrasound-Guided Superficial Cervical Plexus Block on Severity of Pain After Tympano-Mastoidectomy

Preoperative Anxiety Levels and Postoperative Middle Ear Surgery Pain Levels

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