Abstract：
BACKGROUND: Pain and post-operative nausea and vomiting are the main factors that impair the quality of recovery after surgery. Very few reports have analyzed patient-reported outcomes to investigate the efficacy of an enhanced recovery after surgery protocol to alleviate these symptoms after head and neck surgeries with free tissue transfer reconstruction.
METHODS: We investigated post-operative pain and post-operative nausea and vomiting in 47 patients who underwent head and neck surgeries with free tissue transfer reconstruction with enhanced recovery after surgery support between February 2021 and August 2022. Patient-reported outcomes were assessed using the visual analog scale and Japanese version of the Quality of Recovery-40.
RESULTS: Significant increases in the mean visual analog scale scores for pain and post-operative nausea and vomiting were observed only on post-operative Day 1 compared with preoperative values (pain: 3.19 ± 2.78 vs. 1.96 ± 2.42, P = 0.0408; post-operative nausea and vomiting: 1.52 ± 2.09 vs. 0.54 ± 1.37, P = 0.0194). From post-operative Day 2, there were no significant differences between the pre- and post-operative visual analog scale scores, and no significant increases in the incidences of moderate or severe pain and post-operative nausea and vomiting compared with preoperatively. The Japanese version of the Quality of Recovery-40 score for post-operative pain showed no significant deterioration compared with preoperatively, while the Japanese version of the Quality of Recovery-40 score for post-operative nausea and vomiting showed significant deterioration compared with the preoperative value on post-operative Days 2, 4 and 7.
CONCLUSIONS: The visual analog scale and Japanese version of the Quality of Recovery-40 scores for post-operative pain and visual analog scale score for post-operative nausea and vomiting suggested that the enhanced recovery after surgery strategy favorably controlled pain and post-operative nausea and vomiting after head and neck surgeries with free tissue transfer reconstruction. However, as the post-operative Japanese version of the Quality of Recovery-40 score for post-operative nausea and vomiting was lower than the preoperative value, there is still a need for further improvement of the enhanced recovery after surgery pathway.
METHODS: We investigated post-operative pain and post-operative nausea and vomiting in 47 patients who underwent head and neck surgeries with free tissue transfer reconstruction with enhanced recovery after surgery support between February 2021 and August 2022. Patient-reported outcomes were assessed using the visual analog scale and Japanese version of the Quality of Recovery-40.
RESULTS: Significant increases in the mean visual analog scale scores for pain and post-operative nausea and vomiting were observed only on post-operative Day 1 compared with preoperative values (pain: 3.19 ± 2.78 vs. 1.96 ± 2.42, P = 0.0408; post-operative nausea and vomiting: 1.52 ± 2.09 vs. 0.54 ± 1.37, P = 0.0194). From post-operative Day 2, there were no significant differences between the pre- and post-operative visual analog scale scores, and no significant increases in the incidences of moderate or severe pain and post-operative nausea and vomiting compared with preoperatively. The Japanese version of the Quality of Recovery-40 score for post-operative pain showed no significant deterioration compared with preoperatively, while the Japanese version of the Quality of Recovery-40 score for post-operative nausea and vomiting showed significant deterioration compared with the preoperative value on post-operative Days 2, 4 and 7.
CONCLUSIONS: The visual analog scale and Japanese version of the Quality of Recovery-40 scores for post-operative pain and visual analog scale score for post-operative nausea and vomiting suggested that the enhanced recovery after surgery strategy favorably controlled pain and post-operative nausea and vomiting after head and neck surgeries with free tissue transfer reconstruction. However, as the post-operative Japanese version of the Quality of Recovery-40 score for post-operative nausea and vomiting was lower than the preoperative value, there is still a need for further improvement of the enhanced recovery after surgery pathway.
摘要：
背景：疼痛和术后恶心呕吐是影响术后恢复质量的主要因素。很少有报告分析患者报告的结果，以研究手术后增强恢复方案的疗效，以缓解头颈部手术后的这些症状，并进行自由组织转移重建。
方法：我们调查了在2021年2月至2022年8月期间接受头颈部自由组织转移重建手术并在手术支持后恢复增强的47例患者的术后疼痛和术后恶心呕吐。使用视觉模拟量表和日文版的恢复质量-40评估患者报告的结果。
结果：仅在术后第1天观察到疼痛和术后恶心和呕吐的平均视觉模拟评分与术前值相比显着增加（疼痛：3.19±2.78vs.1.96±2.42，P=0.0408；术后恶心呕吐：1.52±2.09vs.0.54±1.37,P=0.0194)。从术后第2天开始，术前和术后视觉模拟量表评分之间没有显着差异，与术前相比，中度或重度疼痛以及术后恶心和呕吐的发生率没有显着增加。日本版本的恢复质量-40评分术后疼痛与术前相比没有明显恶化，而日本版本的手术后恶心和呕吐的恢复质量-40评分与术后第2、4和7天的术前值相比显示显着恶化。
结论：手术后疼痛的视觉模拟量表和日本版的恢复质量-40评分以及手术后恶心和呕吐的视觉模拟量表评分表明，增强的手术后恢复策略可以有利地控制头颈部手术后的疼痛和术后恶心和呕吐，并进行自由组织转移重建。然而,因为手术后日本版本的复苏质量-40评分术后恶心和呕吐低于术前值，仍有必要进一步改善增强术后恢复的手术路径。
方法：我们调查了在2021年2月至2022年8月期间接受头颈部自由组织转移重建手术并在手术支持后恢复增强的47例患者的术后疼痛和术后恶心呕吐。使用视觉模拟量表和日文版的恢复质量-40评估患者报告的结果。
结果：仅在术后第1天观察到疼痛和术后恶心和呕吐的平均视觉模拟评分与术前值相比显着增加（疼痛：3.19±2.78vs.1.96±2.42，P=0.0408；术后恶心呕吐：1.52±2.09vs.0.54±1.37,P=0.0194)。从术后第2天开始，术前和术后视觉模拟量表评分之间没有显着差异，与术前相比，中度或重度疼痛以及术后恶心和呕吐的发生率没有显着增加。日本版本的恢复质量-40评分术后疼痛与术前相比没有明显恶化，而日本版本的手术后恶心和呕吐的恢复质量-40评分与术后第2、4和7天的术前值相比显示显着恶化。
结论：手术后疼痛的视觉模拟量表和日本版的恢复质量-40评分以及手术后恶心和呕吐的视觉模拟量表评分表明，增强的手术后恢复策略可以有利地控制头颈部手术后的疼痛和术后恶心和呕吐，并进行自由组织转移重建。然而,因为手术后日本版本的复苏质量-40评分术后恶心和呕吐低于术前值，仍有必要进一步改善增强术后恢复的手术路径。
