Quality of postoperative pain management after midfacial fracture repair—an outcome-oriented study

Abstract

Objectives

There is a lack of literature regarding the procedure-specific quality of acute postoperative pain management after midfacial fracture repair. The purpose of the presented prospective clinical study was to evaluate postoperative pain management after surgical repair of midfacial fractures.

Materials and methods

Eighty-five adults were evaluated on the first postoperative day following midfacial repair using the questionnaire of the Quality Improvement in Postoperative Pain Management (QUIPS) project. The main outcome measures were patients’ characteristics and clinical- and patient-reported outcome parameters.

Results

Overall, pain on the first postoperative day was moderate. A significant correlation between process and outcome parameters could be shown. Duration of surgery above the calculated median was significantly associated with higher maximum pain intensity (p = 0.017). Patients requiring opioids in the recovery room presented significantly higher pain on activity (p = 0.029) and maximum pain (p = 0.035). Sleeping impairment (p = 0.001) and mood disturbance (p = 0.008) were significantly more prevalent in patients undergoing repair of a centrolateral midfacial fracture.

Conclusions

QUIPS is a simple and qualified tool to evaluate the procedure specific quality of acute postoperative pain management. Pain on the first postoperative day following midfacial fracture repair seems overall to be moderate. Nearly a third of the patients showed inadequate postoperative pain management. To prevent inadequate postoperative pain management, it is necessary to establish a continued procedure-specific outcome measurement.

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Conflict of interest statement

The authors declare that they have no conflict of interest. There were no sources of funding or financial relationships.

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Corresponding author

Correspondence to Gregor F. Raschke.

Additional information

Clinical relevance

Repair of a centrolateral midfacial fracture, long duration of surgery, and need of opioids in the recovery room seem to be associated with higher postoperative pain levels.

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Raschke, G.F., Peisker, A., Rieger, U. et al. Quality of postoperative pain management after midfacial fracture repair—an outcome-oriented study. Clin Oral Invest 19, 619–625 (2015). https://doi.org/10.1007/s00784-014-1283-5

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Keywords

  • Postoperative pain
  • Quality management
  • QUIPS
  • Zygomaticomaxillary complex fracture
  • Blow-out fracture
  • Orbital floor fracture