PDF(Pubmed)
Abstract：
UNASSIGNED: Head and neck malignancy treatment often involves invasive surgeries, necessitating effective postoperative pain control. However, chronic reliance on opioid medications remains a challenge for many patients after surgery. Multimodal analgesia (MMA) within enhanced recovery after surgery protocols has shown success in limiting narcotic pain medications for other cancer types. In a prior study, MMA comprising acetaminophen, ketorolac, gabapentin, and a neurogenic block reduced opioid use in the 7-day postoperative period for major head and neck reconstructive surgery. This study investigates the impact of multimodal analgesia on opioid prescription and pain during the 6-week postoperative period for patients undergoing major head and neck oncologic surgeries, aiming to understand the longer-term effects of narcotic use.
UNASSIGNED: The study retrospectively examined participants in a [hybrid type 1 effectiveness-implementation pragmatic trial to assess multimodal analgesia\'s long-term effectiveness in head and neck free flap surgery. Arm A received scheduled acetaminophen and as-needed opioids, while Arm B received scheduled gabapentin, ketorolac, a regional nerve block at the donor site, scheduled acetaminophen, and as-needed opioids. Retrospective data collection included opioid prescription use and pain scores up to 6 weeks after surgery, gathered from the Kansas prescription drug monitoring program, K-TRACS.
UNASSIGNED: Thirty patients participated, 14 in Arm A and 16 in Arm B. The average morphine milligram equivalents per day of filled prescriptions were not significantly different between Arm A and Arm B (7.23 vs. 7.88, p = .845). Additionally, average pain scores at 6 weeks showed no significant difference between the two groups (1.4 vs. 1.9, p = .612).
UNASSIGNED: Patients with head and neck cancer treated with multimodal analgesia during the perioperative period did not exhibit significant differences in opioid use and pain within 6 weeks after discharge. To confirm these findings, a re-examination with strict measures of opioid use and scheduled pain assessments in a prospective manner is warranted.
UNASSIGNED: 4.
UNASSIGNED: The study retrospectively examined participants in a [hybrid type 1 effectiveness-implementation pragmatic trial to assess multimodal analgesia\'s long-term effectiveness in head and neck free flap surgery. Arm A received scheduled acetaminophen and as-needed opioids, while Arm B received scheduled gabapentin, ketorolac, a regional nerve block at the donor site, scheduled acetaminophen, and as-needed opioids. Retrospective data collection included opioid prescription use and pain scores up to 6 weeks after surgery, gathered from the Kansas prescription drug monitoring program, K-TRACS.
UNASSIGNED: Thirty patients participated, 14 in Arm A and 16 in Arm B. The average morphine milligram equivalents per day of filled prescriptions were not significantly different between Arm A and Arm B (7.23 vs. 7.88, p = .845). Additionally, average pain scores at 6 weeks showed no significant difference between the two groups (1.4 vs. 1.9, p = .612).
UNASSIGNED: Patients with head and neck cancer treated with multimodal analgesia during the perioperative period did not exhibit significant differences in opioid use and pain within 6 weeks after discharge. To confirm these findings, a re-examination with strict measures of opioid use and scheduled pain assessments in a prospective manner is warranted.
UNASSIGNED: 4.
摘要：
■头颈部恶性肿瘤治疗通常涉及侵入性手术，需要有效的术后疼痛控制。然而,长期依赖阿片类药物仍然是许多手术后患者面临的挑战.多模式镇痛（MMA）在增强手术后恢复方案中已显示出成功限制其他癌症类型的麻醉止痛药物。在之前的研究中,包含对乙酰氨基酚的MMA，酮咯酸,加巴喷丁,神经源性阻滞减少了主要头颈部重建手术术后7天的阿片类药物使用。这项研究调查了多模式镇痛对阿片类药物处方和疼痛的影响，在6周的术后期间，接受大头颈部肿瘤手术的患者，旨在了解麻醉药使用的长期影响。
■该研究回顾性检查了一项[混合1型有效性-实施务实试验的参与者，以评估多模式镇痛在头颈部游离皮瓣手术中的长期有效性。A组接受了预定的对乙酰氨基酚和根据需要的阿片类药物，当B臂收到预定的加巴喷丁时，酮咯酸,供体部位的局部神经阻滞,预定的对乙酰氨基酚，和需要的阿片类药物。回顾性数据收集包括阿片类药物处方的使用和术后6周的疼痛评分，从堪萨斯州的处方药监测项目中收集到的，K-TRACS.
■30名患者参加了A组中14例，B组中16例。A组和B组之间每天的平均吗啡毫克当量没有显着差异（7.23vs.7.88，p=.845）。此外,6周时的平均疼痛评分显示两组之间没有显着差异（1.4vs.1.9，p=.612）。
■围手术期接受多模式镇痛治疗的头颈癌患者在出院后6周内在阿片类药物使用和疼痛方面没有显着差异。为了证实这些发现,有必要以前瞻性方式进行严格的阿片类药物使用和计划疼痛评估的重新检查.
■4.
■该研究回顾性检查了一项[混合1型有效性-实施务实试验的参与者，以评估多模式镇痛在头颈部游离皮瓣手术中的长期有效性。A组接受了预定的对乙酰氨基酚和根据需要的阿片类药物，当B臂收到预定的加巴喷丁时，酮咯酸,供体部位的局部神经阻滞,预定的对乙酰氨基酚，和需要的阿片类药物。回顾性数据收集包括阿片类药物处方的使用和术后6周的疼痛评分，从堪萨斯州的处方药监测项目中收集到的，K-TRACS.
■30名患者参加了A组中14例，B组中16例。A组和B组之间每天的平均吗啡毫克当量没有显着差异（7.23vs.7.88，p=.845）。此外,6周时的平均疼痛评分显示两组之间没有显着差异（1.4vs.1.9，p=.612）。
■围手术期接受多模式镇痛治疗的头颈癌患者在出院后6周内在阿片类药物使用和疼痛方面没有显着差异。为了证实这些发现,有必要以前瞻性方式进行严格的阿片类药物使用和计划疼痛评估的重新检查.
■4.
