Postoperative pain assessment after septorhinoplasty

Abstract

Postoperative pain after septorhinoplasty and its optimal management has not been described in detail. Fifty-two adult septorhinoplasty patients were included in a prospective cohort single center study. Patients' and surgical characteristics were evaluated. Outcome and process parameters were analyzed using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Management (QUIPS) on the first postoperative day. Pain during the first operative day after septorhinoplasty was moderate. Pain management predominately consisted of remifentanil intraoperatively, metamizole in the recovery room, in combination with piritramide in one-third of the patients, and metamizole on ward. Patients younger than 31 years were less satisfied with pain management (P = 0.018). Open rhinoplasty was associated with less satisfaction with pain management (P = 0.007). Use of rib grafts led to more mobility, breathing, sleeping and mood disturbances (P = 0.003, 0.047; 0.047; 0.022, respectively). Preoperative pain counseling was followed by higher satisfaction, less breathing and mood disturbances after surgery (P = 0.021; 0.004; 0.046, respectively). Opioids in the recovery room in addition to non-opioids and treatment with non-opioids on ward led to less maximal pain (P = 0.027 and 0.040, respectively). We conclude that QUIPS is an easy tool to evaluate the quality of postoperative pain management following rhinoplasty. Preoperative pain counseling, specific care for patients with rib grafts, consequent use of opioids in the recovery room in addition to non-opioids, and use of non-opioids on ward seem to be effective to improve pain management after septorhinoplasty.

Pain on the first postoperative day after head and neck cancer surgery

“…The presented results strongly suggest that cold packs are ineffective to treat perioperative pain or were not given until the patients complained of pain. This ineffectiveness has been shown in some recent studies also for other types of head and neck surgery [9][10][11]. The results may suggest to implement procedurespecific pain-treatment protocols including fixed drug combinations, for instance by a combination of a prophylactic non-opioid and opioid ''around-the-clock'' medication, complemented by an effective on-demand opioid titration Interestingly, in recent studies not specifically directed to cancer patients preoperative pain counseling was an important, independent and possibly neglected Eur Arch Otorhinolaryngol factor to reduce postoperative pain [18].…”

“…Staging was based on the 7th edition of the AJCC Cancer Staging Classification 2010 for head and neck [8]. The questionnaires are presented in detail elsewhere [9][10][11]. All data were made anonymous and transferred via internet (http://www.quips-projekt.de/) to the external database for the benchmark project of QUIPS allowing an anonymous comparison to the results of other participating hospitals.…”

Rinoplasti Operasyonu Sonrasi Yapılan Ek Lokal Anestezinin Postoperatif Agri Duzeyine olan Etkisi

“…Osteotomi yapılması, ek septal girişimler, konkal veya kostal kıkırdak greft kullanımı, operasyon süresi gibi etkenler postoperatif dönemde ağrı düzeyini etkileyen faktrörlerdendir (4). Kapalı rinoplasti sonrası pek çok cerrahın klinik tecrübesi hastaların ameliyat sonrası süreci daha az ödem, morluk ve ağrı ile geçirdiği yönündedir.…”

“…Rinoplasti operasyonları sonrası ağrı düzeyi cerrahinin kapsamı, septum ve konkaya müdahale, osteotomi yapılıp yapılmaması, açık ve kapalı teknik kullanılması ile ilgili olabileceği gibi, hastaların farklılık gösteren ağrı eşikleri ve kullanılan postoperatif analjezi rejiminden de etkilenebilir (4). Bunlara ilave olarak postoperatif erken dönemde ağrı düzeyini etkileyen diğer bir faktör de uygulanan lokal anestezinin çeşidi ve zamanlamasıdır (5,6).…”

Abstracts from the 4th Grazer Risk Day: Patient Safety in Routine

“…These manuscripts cover a wide range of different research questions from basic psychometric questions (item order, number or response levels) [8,9], the analysis of a special type of surgery (e.g. septorhinoplasty) [10] to an overview of a wide range of surgeries [11]. Beside these scientifically high impact manuscripts several manuscripts have been published reporting the experience of single hospitals with the QUIPS registry [12].…”