Skip to main content
SpringerLink
Log in

Evidence-Based Perioperative Analgesia for Otolaryngology: Head and Neck Surgery

  • Chapter
  • First Online:
Perioperative Pain Control: Tools for Surgeons

Abstract

Perioperative pain management has been a major discussion topic as narcotic abuse and overdose deaths have dramatically increased over recent decades. Otolaryngologists have a duty to provide adequate postoperative pain relief in a responsible manner. Analgesic regimens are dependent on patient factors including age, gender, pre-procedural pain, and, most importantly, surgical site and type of procedure. A majority of procedures in otolaryngology are appropriately managed through non-opioid alternatives, and there are high levels of evidence supporting local anesthetics, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), and gabapentin use. These multimodal regimens enable effective pain control and decrease the number of opioids prescribed to patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Thompson AR. Opioids and their proper use as analgesics in the management of head and neck cancer patients. Am J Otolaryngol. 2000;21(4):244–54. https://doi.org/10.1053/ajot.2000.0210244.

    Article  CAS  PubMed  Google Scholar 

  2. Dort JC, Farwell DG, Findlay M, et al. Optimal perioperative care in major head and neck cancer surgery with free flap reconstruction: a consensus review and recommendations from the enhanced recovery after surgery society. JAMA Otolaryngol Head Neck Surg. 2017;143(3):292–303. https://doi.org/10.1001/jamaoto.2016.2981.

    Article  PubMed  Google Scholar 

  3. Oltman J, Militsakh O, D’Agostino M, et al. Multimodal analgesia in outpatient head and neck surgery: a feasibility and safety study. JAMA Otolaryngol Head Neck Surg. 2017;143(12):1207–12. https://doi.org/10.1001/jamaoto.2017.1773.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Du E, Farzal Z, Stephenson E, et al. Multimodal analgesia protocol after head and neck surgery: effect on opioid use and pain control. Otolaryngol Head Neck Surg. 2019;161(3):424–30. https://doi.org/10.1177/0194599819841885.

    Article  PubMed  Google Scholar 

  5. Bahl V, Shuman AG, Hu HM, et al. Chemoprophylaxis for venous thromboembolism in otolaryngology. JAMA Otolaryngol Head Neck Surg. 2014;140(11):999–1005. https://doi.org/10.1001/jamaoto.2014.2254.

    Article  PubMed  Google Scholar 

  6. Schleiffarth JR, Bayon R, Chang KE, Van Daele DJ, Pagedar NA. Ketorolac after free tissue transfer: a comparative effectiveness study. Ann Otol Rhinol Laryngol. 2014;123(6):446–9. https://doi.org/10.1177/0003489414526849.

    Article  PubMed  Google Scholar 

  7. Smith E, Lange J, Moore C, Eid I, Jackson L, Monico J. The role of intravenous acetaminophen in post-operative pain control in head and neck cancer patients. Laryngoscope Investig Otolaryngol. 2019;4(2):250–4. https://doi.org/10.1002/lio2.254.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Simpson JC, Bao X, Agarwala A. Pain management in enhanced recovery after surgery (ERAS) protocols. Clin Colon Rectal Surg. 2019;32(2):121–8. https://doi.org/10.1055/s-0038-1676477.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ljungqvist O, Hubner M. Enhanced recovery after surgery-ERAS-principles, practice and feasibility in the elderly. Aging Clin Exp Res. 2018;30(3):249–52. https://doi.org/10.1007/s40520-018-0905-1.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ljungqvist O, Thanh NX, Nelson G. ERAS-value based surgery. J Surg Oncol. 2017;116(5):608–12. https://doi.org/10.1002/jso.24820.

    Article  PubMed  Google Scholar 

  11. Adogwa O, Elsamadicy AA, Fialkoff J, Cheng J, Karikari IO, Bagley C. Early ambulation decreases length of hospital stay, perioperative complications and improves functional outcomes in elderly patients undergoing surgery for correction of adult degenerative scoliosis. Spine. 2017;42(18):1420–5. https://doi.org/10.1097/BRS.0000000000002189.

    Article  PubMed  Google Scholar 

  12. Steffens D, Beckenkamp PR, Hancock M, Solomon M, Young J. Preoperative exercise halves the postoperative complication rate in patients with lung cancer: a systematic review of the effect of exercise on complications, length of stay and quality of life in patients with cancer. Br J Sports Med. 2018;52(5):344. https://doi.org/10.1136/bjsports-2017-098032.

    Article  PubMed  Google Scholar 

  13. Pirson M, Dehanne F, Van den Bulcke J, Leclercq P, Martins D, De Wever A. Evaluation of cost and length of stay, linked to complications associated with major surgical procedures. Acta Clin Belg. 2018;73(1):40–9. https://doi.org/10.1080/17843286.2017.1338850.

    Article  CAS  PubMed  Google Scholar 

  14. Lee TS, Wang LL, Yi DI, Prasanna PD, Kandl C. Opioid sparing multimodal analgesia treats pain after head and neck microvascular reconstruction. Laryngoscope. 2019; https://doi.org/10.1002/lary.28402.

  15. Chiu TW, Leung CCH, Lau EYK, Burd A. Analgesic effects of preoperative gabapentin after tongue reconstruction with the anterolateral thigh flap. Hong Kong Med J. 2012;18(1):30–4.

    CAS  PubMed  Google Scholar 

  16. Strecker WB, Wood MB, Wedel DJ. Epidural anesthesia during lower extremity free tissue transfer. J Reconstr Microsurg. 1988;4(4):327–9. https://doi.org/10.1055/s-2007-1006939.

    Article  CAS  PubMed  Google Scholar 

  17. Erni D, Banic A, Signer C, Sigurdsson GH. Effects of epidural anaesthesia on microcirculatory blood flow in free flaps in patients under general anaesthesia. Eur J Anaesthesiol. 1999;16(10):692–8. https://doi.org/10.1046/j.1365-2346.1999.00565.x.

    Article  CAS  PubMed  Google Scholar 

  18. Delis KT, Knaggs AL, Mason P, Macleod KG. Effects of epidural-and-general anesthesia combined versus general anesthesia alone on the venous hemodynamics of the lower limb. A randomized study. Thromb Haemost. 2004;92(5):1003–11. https://doi.org/10.1160/TH04-04-0233.

    Article  CAS  PubMed  Google Scholar 

  19. Affairs (ASPA) AS of P. What is the U.S. Opioid Epidemic? HHS.gov. https://www.hhs.gov/opioids/about-the-epidemic/index.html. Published December 4, 2017. Accessed 13 Jan 2020.

  20. Steele DW, Adam GP, Di M, Halladay CH, Balk EM, Trikalinos TA. Effectiveness of tympanostomy tubes for otitis media: a meta-analysis. Pediatrics. 2017;139(6) https://doi.org/10.1542/peds.2017-0125.

  21. Campbell HT, Yuhan BT, Smith B, et al. Perioperative analgesia for patients undergoing otologic surgery: an evidence-based review. Laryngoscope. 2020;130(1):190–9. https://doi.org/10.1002/lary.27872.

    Article  PubMed  Google Scholar 

  22. Watcha MF, Ramirez-Ruiz M, White PF, Jones MB, Lagueruela RG, Terkonda RP. Perioperative effects of oral ketorolac and acetaminophen in children undergoing bilateral myringotomy. Can J Anaesth. 1992;39(7):649–54. https://doi.org/10.1007/BF03008224.

    Article  CAS  PubMed  Google Scholar 

  23. Bean-Lijewski JD, Stinson JC. Acetaminophen or ketorolac for post myringotomy pain in children? A prospective, double-blinded comparison. Paediatr Anaesth. 1997;7(2):131–7. https://doi.org/10.1046/j.1460-9592.1997.d01-47.x.

    Article  CAS  PubMed  Google Scholar 

  24. Tobias JD, Lowe S, Hersey S, Rasmussen GE, Werkhaven J. Analgesia after bilateral myringotomy and placement of pressure equalization tubes in children: acetaminophen versus acetaminophen with codeine. Anesth Analg. 1995;81(3):496–500. https://doi.org/10.1097/00000539-199509000-00012.

    Article  CAS  PubMed  Google Scholar 

  25. Lin Y-C, Tassone RF, Jahng S, et al. Acupuncture management of pain and emergence agitation in children after bilateral myringotomy and tympanostomy tube insertion. Paediatr Anaesth. 2009;19(11):1096–101. https://doi.org/10.1111/j.1460-9592.2009.03129.x.

    Article  PubMed  Google Scholar 

  26. Bhandari G, Shahi KS, Parmar NK, Asad M, Joshi HK, Bhakuni R. Evaluation of analgesic effect of two different doses of fentanyl in combination with bupivacaine for surgical site infiltration in cases of modified radical mastoidectomy: a double blind randomized study. Anesth Essays Res. 2013;7(2):243–7. https://doi.org/10.4103/0259-1162.118979.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Nalini R, Ezhilramya J. A comparative study of efficacy and safety of lornoxicam and diclofenac as postoperative analgesics after mastoidectomy surgery. 2017; https://doi.org/10.22159/ijpps.2017v9i2.15091.

  28. Suresh S, Barcelona SL, Young NM, Seligman I, Heffner CL, Coté CJ. Postoperative pain relief in children undergoing tympanomastoid surgery: is a regional block better than opioids? Anesth Analg. 2002;94(4):859–62., table of contents. https://doi.org/10.1097/00000539-200204000-00015.

    Article  CAS  PubMed  Google Scholar 

  29. Suresh S, Barcelona SL, Young NM, Heffner CL, Coté CJ. Does a preemptive block of the great auricular nerve improve postoperative analgesia in children undergoing tympanomastoid surgery? Anesth Analg. 2004;98(2):330–3., table of contents. https://doi.org/10.1213/01.ane.0000097171.73374.ad.

    Article  PubMed  Google Scholar 

  30. Niiyama Y, Yotsuyanagi T, Yamakage M. Continuous wound infiltration with 0.2% ropivacaine versus a single intercostal nerve block with 0.75% ropivacaine for postoperative pain management after reconstructive surgery for microtia. J Plast Reconstr Aesthet Surg. 2016;69(10):1445–9. https://doi.org/10.1016/j.bjps.2016.05.009.

    Article  PubMed  Google Scholar 

  31. Mesolella M, Lamarca S, Galli V, Ricciardiello F, Cavaliere M, Iengo M. Use of remifentanil for sedo-analgesia in stapedotomy: personal experience. Acta Otorhinolaryngol Ital. 2004;24(6):315–20.

    CAS  PubMed  Google Scholar 

  32. Parikh DA, Kolli SN, Karnik HS, Lele SS, Tendolkar BA. A prospective randomized double-blind study comparing dexmedetomidine vs. combination of midazolam-fentanyl for tympanoplasty surgery under monitored anesthesia care. J Anaesthesiol Clin Pharmacol. 2013;29(2):173–8. https://doi.org/10.4103/0970-9185.111671.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Nallam SR, Chiruvella S, Reddy A. Monitored anaesthesia care – comparison of nalbuphine/dexmedetomidine versus nalbuphine/propofol for middle ear surgeries: a double-blind randomised trial. Indian J Anaesth. 2017;61(1):61–7. https://doi.org/10.4103/0019-5049.198403.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Sommer M, Geurts JWJM, Stessel B, et al. Prevalence and predictors of postoperative pain after ear, nose, and throat surgery. Arch Otolaryngol Head Neck Surg. 2009;135(2):124–30. https://doi.org/10.1001/archoto.2009.3.

    Article  PubMed  Google Scholar 

  35. Chou R, Gordon DB, de Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131–57. https://doi.org/10.1016/j.jpain.2015.12.008.

    Article  PubMed  Google Scholar 

  36. Cramer JD, Wisler B, Gouveia CJ. Opioid stewardship in otolaryngology: state of the art review. Otolaryngol Head Neck Surg. 2018;158(5):817–27. https://doi.org/10.1177/0194599818757999.

    Article  PubMed  Google Scholar 

  37. Morin C, Lund JP, Villarroel T, Clokie CM, Feine JS. Differences between the sexes in post-surgical pain. Pain. 2000;85(1–2):79–85. https://doi.org/10.1016/s0304-3959(99)00248-1.

    Article  CAS  PubMed  Google Scholar 

  38. Kalkman CJ, Visser K, Moen J, Bonsel GJ, Grobbee DE, Moons KGM. Preoperative prediction of severe postoperative pain. Pain. 2003;105(3):415–23. https://doi.org/10.1016/s0304-3959(03)00252-5.

    Article  CAS  PubMed  Google Scholar 

  39. Bisgaard T, Klarskov B, Rosenberg J, Kehlet H. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain. 2001;90(3):261–9. https://doi.org/10.1016/s0304-3959(00)00406-1.

    Article  PubMed  Google Scholar 

  40. Huston MN, Kamizi R, Meyer TK, Merati AL, Giliberto JP. Current opioid prescribing patterns after microdirect laryngoscopy. Ann Otol Rhinol Laryngol. 2019; https://doi.org/10.1177/0003489419877912.

  41. Compton WM, Volkow ND. Major increases in opioid analgesic abuse in the United States: concerns and strategies. Drug Alcohol Depend. 2006;81(2):103–7. https://doi.org/10.1016/j.drugalcdep.2005.05.009.

    Article  PubMed  Google Scholar 

  42. Svider PF, Arianpour K, Guo E, et al. Opioid prescribing patterns among otolaryngologists: crucial insights among the medicare population. Laryngoscope. 2018;128(7):1576–81. https://doi.org/10.1002/lary.27101.

    Article  PubMed  Google Scholar 

  43. Orgill R, Krempl GA, Medina JE. Acute pain management following laryngectomy. Arch Otolaryngol Head Neck Surg. 2002;128(7):829–32. https://doi.org/10.1001/archotol.128.7.829.

    Article  PubMed  Google Scholar 

  44. Carr DB, Jacox AK, Chapman CR, et al. Acute pain management in adults: operative procedures, quick reference guide for clinicians. J Pain Palliat Care Pharmacother. 1993;1(1):63–84.

    Google Scholar 

  45. Follin SL, Charland SL. Acute pain management: operative or medical procedures and trauma. Ann Pharmacother. 1997;31(9):1068–76. https://doi.org/10.1177/106002809703100917.

    Article  CAS  PubMed  Google Scholar 

  46. Bové MJ, Jabbour N, Krishna P, et al. Operating room versus office-based injection laryngoplasty: a comparative analysis of reimbursement. Laryngoscope. 2007;117(2):226–30. https://doi.org/10.1097/01.mlg.0000250898.82268.39.

    Article  PubMed  Google Scholar 

  47. Rosen CA, Amin MR, Sulica L, et al. Advances in office-based diagnosis and treatment in laryngology. Laryngoscope. 2009;119(Suppl 2):S185–212. https://doi.org/10.1002/lary.20712.

    Article  PubMed  Google Scholar 

  48. Simpson CB, Amin MR, Postma GN. Topical anesthesia of the airway and esophagus. Ear Nose Throat J. 2004;83(7 Suppl 2):2–5.

    PubMed  Google Scholar 

  49. Sulica L, Blitzer A. Anesthesia for laryngeal surgery in the office. Laryngoscope. 2000;110(10) Pt 1:1777–9. https://doi.org/10.1097/00005537-200010000-00040.

    Article  CAS  PubMed  Google Scholar 

  50. Sharma GK, Verma SP. Is nebulized lidocaine adequate topical anesthesia for diagnostic transnasal tracheoscopy? Ann Otol Rhinol Laryngol. 2015;124(7):545–9. https://doi.org/10.1177/0003489415570929.

    Article  PubMed  Google Scholar 

  51. Chung DC, Mainland PA, Kong AS. Anesthesia of the airway by aspiration of lidocaine. Can J Anaesth. 1999;46(3):215–9. https://doi.org/10.1007/BF03012598.

    Article  CAS  PubMed  Google Scholar 

  52. Crawley BK, Dehom S, Kutzner E, Murry T, Krishna P, Hata J. Perception and duration of pain after office-based vocal fold injection augmentation. Laryngoscope. 2018;128(4):929–34. https://doi.org/10.1002/lary.27061.

    Article  PubMed  Google Scholar 

  53. Groenewald CB, Rabbitts JA, Schroeder DR, Harrison TE. Prevalence of moderate-severe pain in hospitalized children. Paediatr Anaesth. 2012;22(7):661–8. https://doi.org/10.1111/j.1460-9592.2012.03807.x.

    Article  PubMed  Google Scholar 

  54. Verghese ST, Hannallah RS. Acute pain management in children. J Pain Res. 2010;3:105–23.

    Article  CAS  Google Scholar 

  55. Srouji R, Ratnapalan S, Schneeweiss S. Pain in children: assessment and nonpharmacological management. Int J Pediatr. 2010; https://doi.org/10.1155/2010/474838.

  56. Abu-Saad HH, Hamers JP. Decision-making and paediatric pain: a review. J Adv Nurs. 1997;26(5):946–52. https://doi.org/10.1046/j.1365-2648.1997.00416.x.

    Article  CAS  PubMed  Google Scholar 

  57. McGrath PJ, Latimer M, Finley GA, Chambers CT. Measurement of pain in children. Pain Res Manag. 2009;14(1):11.

    Article  Google Scholar 

  58. Rodríguez MC, Villamor P, Castillo T. Assessment and management of pain in pediatric otolaryngology. Int J Pediatr Otorhinolaryngol. 2016;90:138–49. https://doi.org/10.1016/j.ijporl.2016.09.015.

    Article  PubMed  Google Scholar 

  59. Kelly LE, Sommer DD, Ramakrishna J, et al. Morphine or Ibuprofen for post-tonsillectomy analgesia: a randomized trial. Pediatrics. 2015;135(2):307–13. https://doi.org/10.1542/peds.2014-1906.

    Article  PubMed  Google Scholar 

  60. Franz AM, Dahl JP, Huang H, et al. The development of an opioid sparing anesthesia protocol for pediatric ambulatory tonsillectomy and adenotonsillectomy surgery-a quality improvement project. Paediatr Anaesth. 2019;29(7):682–9. https://doi.org/10.1111/pan.13662.

    Article  PubMed  Google Scholar 

  61. DeHart AN, Potter J, Anderson J, et al. Perioperative interdisciplinary approach for reduction of opioid use in pediatric tonsillectomy: protocol using dexmedetomidine and bupivacaine as adjunct agents. Am J Otolaryngol. 2019;40(3):382–8. https://doi.org/10.1016/j.amjoto.2019.02.007.

    Article  PubMed  Google Scholar 

  62. Hwang SH, Park IJ, Cho YJ, Jeong YM, Kang JM. The efficacy of gabapentin/pregabalin in improving pain after tonsillectomy: a meta-analysis. Laryngoscope. 2016;126(2):357–66. https://doi.org/10.1002/lary.25636.

    Article  CAS  PubMed  Google Scholar 

  63. Michael A, Buchinsky FJ, Isaacson G. Safety of preoperative ibuprofen in pediatric tonsillectomy. Laryngoscope. 2018;128(10):2415–8. https://doi.org/10.1002/lary.27241.

    Article  CAS  PubMed  Google Scholar 

  64. Martin AL, McGrath PA, Brown SC, Katz J. Anxiety sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain. Pain Res Manag. 2007;12(4):267–72.

    Article  Google Scholar 

  65. Fisher E, Heathcote LC, Eccleston C, Simons LE, Palermo TM. Assessment of pain anxiety, pain catastrophizing, and fear of pain in children and adolescents with chronic pain: a systematic review and meta-analysis. J Pediatr Psychol. 2018;43(3):314–25. https://doi.org/10.1093/jpepsy/jsx103.

    Article  PubMed  Google Scholar 

  66. Russell P, von Ungern-Sternberg BS, Schug SA. Perioperative analgesia in pediatric surgery. Curr Opin Anaesthesiol. 2013;26(4):420–7. https://doi.org/10.1097/ACO.0b013e3283625cc8.

    Article  CAS  PubMed  Google Scholar 

  67. Boric K, Dosenovic S, Jelicic Kadic A, et al. Interventions for postoperative pain in children: an overview of systematic reviews. Paediatr Anaesth. 2017;27(9):893–904. https://doi.org/10.1111/pan.13203.

    Article  PubMed  Google Scholar 

  68. Whelan RL, McCoy J, Mirson L, Chi DH. Opioid prescription and postoperative outcomes in pediatric patients. Laryngoscope. 2019;129(6):1477–81. https://doi.org/10.1002/lary.27614.

    Article  PubMed  Google Scholar 

  69. Garren BR, Lawrence MB, McNaull PP, et al. Opioid-prescribing patterns, storage, handling, and disposal in postoperative pediatric urology patients. J Pediatr Urol. 2019;15(3):260.e1–7. https://doi.org/10.1016/j.jpurol.2019.02.009.

    Article  CAS  Google Scholar 

  70. Reddy A, de la Cruz M, Rodriguez EM, et al. Patterns of storage, use, and disposal of opioids among cancer outpatients. Oncologist. 2014;19(7):780–5. https://doi.org/10.1634/theoncologist.2014-0071.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Vessey JA, Carlson KL, McGill J. Use of distraction with children during an acute pain experience. Nurs Res. 1994;43(6):369–72.

    Article  CAS  Google Scholar 

  72. Tak JH, van Bon WHJ. Pain- and distress-reducing interventions for venepuncture in children. Child Care Health Dev. 2006;32(3):257–68. https://doi.org/10.1111/j.1365-2214.2006.00578.x.

    Article  CAS  PubMed  Google Scholar 

  73. Lane E, Latham T. Managing pain using heat and cold therapy. Paediatr Nurs. 2009;21(6):14–8. https://doi.org/10.7748/paed2009.07.21.6.14.c7146.

    Article  PubMed  Google Scholar 

  74. Spicuzza L, Caruso D, Di Maria G. Obstructive sleep apnoea syndrome and its management. Ther Adv Chronic Dis. 2015;6(5):273–85. https://doi.org/10.1177/2040622315590318.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Rombaux P, Hamoir M, Bertrand B, Aubert G, Liistro G, Rodenstein D. Postoperative pain and side effects after uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring. Laryngoscope. 2003;113(12):2169–73. https://doi.org/10.1097/00005537-200312000-00023.

    Article  PubMed  Google Scholar 

  76. Ladha KS, Neuman MD, Broms G, et al. Opioid prescribing after surgery in the United States, Canada, and Sweden. JAMA Netw Open. 2019;2(9):e1910734. https://doi.org/10.1001/jamanetworkopen.2019.10734.

    Article  PubMed  PubMed Central  Google Scholar 

  77. McClain K, Williams AM, Yaremchuk K. Ketorolac usage in tonsillectomy and uvulopalatopharyngoplasty patients. Laryngoscope. 2019; https://doi.org/10.1002/lary.28077.

  78. Fujita H, Tanaka J, Maeda N, Sakanaka M. Adrenergic agonists suppress the proliferation of microglia through β2-adrenergic receptor. Neurosci Lett. 1998;242(1):37–40. https://doi.org/10.1016/S0304-3940(98)00003-2.

    Article  CAS  PubMed  Google Scholar 

  79. Holty J-EC, Guilleminault C. Surgical options for the treatment of obstructive sleep apnea. Med Clin North Am. 2010;94(3):479–515. https://doi.org/10.1016/j.mcna.2010.02.001.

    Article  PubMed  Google Scholar 

  80. Ponstein NA, Kim T-WE, Hsia J, Goode R, Borges P, Mariano ER. Continuous lesser palatine nerve block for postoperative analgesia after uvulopalatopharyngoplasty. Clin J Pain. 2013;29(12):e35–8. https://doi.org/10.1097/AJP.0b013e3182971887.

    Article  PubMed  Google Scholar 

  81. Day KM, Nair NM, Sargent LA. Extended release liposomal bupivacaine injection (Exparel) for early postoperative pain control following palatoplasty. J Craniofac Surg. 2018;29(5):e525–8. https://doi.org/10.1097/SCS.0000000000004591.

    Article  PubMed  Google Scholar 

  82. Li L, Feng J, Xie S, Geng L. Preemptive submucosal infiltration with ropivacaine for uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg. 2014;151(5):874–9. https://doi.org/10.1177/0194599814545726.

    Article  PubMed  Google Scholar 

  83. Neruntarat C. Genioglossus advancement and hyoid myotomy under local anesthesia. Otolaryngol Head Neck Surg. 2003;129(1):85–91. https://doi.org/10.1016/s0194-5998(03)00094-9.

    Article  PubMed  Google Scholar 

  84. Sclafani AP, Kim M, Kjaer K, Kacker A, Tabaee A. Postoperative pain and analgesic requirements after septoplasty and rhinoplasty. Laryngoscope. 2019;129(9):2020–5. https://doi.org/10.1002/lary.27913.

    Article  PubMed  Google Scholar 

  85. Haytoğlu S, Kuran G, Muluk NB, Arıkan OK. Different anesthetic agents-soaked sinus packings on pain management after functional endoscopic sinus surgery: which is the most effective? Eur Arch Otorhinolaryngol. 2016;273(7):1769–77. https://doi.org/10.1007/s00405-015-3807-2.

    Article  PubMed  Google Scholar 

  86. Al-Qudah M. Endoscopic sphenopalatine ganglion blockade efficacy in pain control after endoscopic sinus surgery. Int Forum Allergy Rhinol. 2016;6(3):334–8.

    Article  Google Scholar 

  87. Cekic B, Geze S, Erturk E, Akdogan A, Eroglu A. A comparison of levobupivacaine and levobupivacaine-tramadol combination in bilateral infraorbital nerve block for postoperative analgesia after nasal surgery. Ann Plast Surg. 2013;70(2):131–4.

    Article  CAS  Google Scholar 

  88. DeMaria S, Govindaraj S, Chinosorvatana N, Kang S, Levine A. Bilateral sphenopalatine ganglion blockade improves postoperative analgesia after endoscopic sinus surgery. Am J Rhinol Allergy. 2012;26(1):e23–7.

    Article  Google Scholar 

  89. Svider PF, Nguyen B, Yuhan B, Zuliani G, Eloy JA, Folbe AJ. Perioperative analgesia for patients undergoing endoscopic sinus surgery: an evidence-based review. Int Forum Allergy Rhinol. 2018;8(7):837–49. https://doi.org/10.1002/alr.22107.

    Article  PubMed  Google Scholar 

  90. Nguyen BK, Yuhan BT, Folbe E, et al. Perioperative analgesia for patients undergoing Septoplasty and Rhinoplasty: an evidence-based review. Laryngoscope. 2019;129(6):E200–12. https://doi.org/10.1002/lary.27616.

    Article  PubMed  Google Scholar 

  91. Friedman M, Venkatesan T, Lang D, Caldarelli D. Bupivacaine for postoperative analgesia following endoscopic sinus surgery. Laryngoscope. 1996;106(11):1382–5.

    Article  CAS  Google Scholar 

  92. Kesimci E, Öztürk L, Bercin S, Kırış M, Eldem A, Kanbak O. Role of sphenopalatine ganglion block for postoperative analgesia after functional endoscopic sinus surgery. Eur Arch Otorhinolaryngol. 2012;269(1):165–9.

    Article  Google Scholar 

  93. Mariano E, Watson D, Loland V, et al. Bilateral infraorbital nerve blocks decrease postoperative pain but do not reduce time to discharge following outpatient nasal surgery. Journal Canadien D’anesthesie [Can J Anaesth]. 2009;56(8):584–9.

    Article  Google Scholar 

  94. Waldman S. Sphenopalatine ganglion block via the transnasal approach. Atlas Pain Manag Inj Techniq. 2017:57–9.

    Google Scholar 

  95. Waldman S. Sphenopalatine ganglion block: transnasal approach. Atlas Interv Pain Manag. 2015:11–4.

    Google Scholar 

  96. Scott GM, Diamond C, Micomonaco DC. Assessment of a lateral nasal wall block technique for endoscopic sinus surgery under local anesthesia. Am J Rhinol Allergy. 2018;32(4):318–22. https://doi.org/10.1177/1945892418770263.

    Article  PubMed  Google Scholar 

  97. Koteswara C, Sheetal D. A study on pre-emptive analgesic effect of intravenous paracetamol in functional endoscopic sinus surgeries: a randomized, double-blinded clinical study. J Clin Diagn Res. 2014;8(1):108–11.

    Article  Google Scholar 

  98. Kemppainen T, Kokki H, Tuomilehto H, Seppä J, Nuutinen J. Acetaminophen is highly effective in pain treatment after endoscopic sinus surgery. Laryngoscope. 2006;116(12):2125–8.

    Article  CAS  Google Scholar 

  99. Kemppainen T, Tuomilehto H, Kokki H, Seppä J, Nuutinen J. Pain treatment and recovery after endoscopic sinus surgery. Laryngoscope. 2007;117(8):1434–8.

    Article  Google Scholar 

  100. Tyler M, Lam K, Ashoori F, et al. Analgesic effects of intravenous acetaminophen vs placebo for endoscopic sinus surgery and postoperative pain: a randomized clinical trial. JAMA Otolaryngol Head Neck Surg. 2017;143(8):788–94.

    Article  Google Scholar 

  101. Elhakim M. A comparison of intravenous ketoprofen with pethidine for postoperative pain relief following nasal surgery. Acta Anaesthesiol Scand. 1991;35(4):279–82.

    Article  CAS  Google Scholar 

  102. Leykin Y, Casati A, Rapotec A, et al. Comparison of parecoxib and proparacetamol in endoscopic nasal surgery patients. Yonsei Med J. 2008;49(3):383–8.

    Article  CAS  Google Scholar 

  103. Moeller C, Pawlowski J, Pappas A, Fargo K, Welch K. The safety and efficacy of intravenous ketorolac in patients undergoing primary endoscopic sinus surgery: a randomized, double-blinded clinical trial. Int Forum Allergy Rhinol. 2012;2(4):342–7.

    Article  Google Scholar 

  104. Turan A, Memiş D, Karamanlioğlu B, Yağiz R, Pamukçu Z, Yavuz E. The analgesic effects of gabapentin in monitored anesthesia care for ear-nose-throat surgery. Anesth Analg. 2004;99(2):375–8. table of contents

    Article  CAS  Google Scholar 

  105. Guven DG, Demiraran Y, Sezen G, Kepek O, Iskender A. Evaluation of outcomes in patients given dexmedetomidine in functional endoscopic sinus surgery. Ann Otol Rhinol Laryngol. 2011;120(9):586–92. https://doi.org/10.1177/000348941112000906.

    Article  PubMed  Google Scholar 

  106. Karaaslan K, Yilmaz F, Gulcu N, Colak C, Sereflican M, Kocoglu H. Comparison of dexmedetomidine and midazolam for monitored anesthesia care combined with tramadol via patient-controlled analgesia in endoscopic nasal surgery: a prospective, randomized, double-blind, clinical study. Curr Ther Res Clin Exp. 2007;68(2):69–81.

    Article  CAS  Google Scholar 

  107. Karabayirli S, Ugur K, Demircioglu R, et al. Surgical conditions during FESS; comparison of dexmedetomidine and remifentanil. Eur Arch Otorhinolaryngol. 2017;274(1):239–45.

    Article  Google Scholar 

  108. Humphreys MR, Grant D, McKean SA, Eng CY, Townend J, Evans AS. Xylometazoline hydrochloride 0.1 per cent versus physiological saline in nasal surgical aftercare: a randomised, single-blinded, comparative clinical trial. J Laryngol Otol. 2008;123:1–6.

    Google Scholar 

  109. Tang C, Huang X, Kang F, et al. Intranasal dexmedetomidine on stress hormones, inflammatory markers, and postoperative analgesia after functional endoscopic sinus surgery. Mediat Inflamm. 2015; https://doi.org/10.1155/2015/939431.

  110. Bicer C, Eskitascioglu T, Aksu R, Ulgey A, Yildiz K, Madenoglu H. Comparison of preincisional infiltrated levobupivacaine and ropivacaine for acute postoperative pain relief after Septorhinoplasty. Curr Ther Res Clin Exp. 2011;72(1):13–22. https://doi.org/10.1016/j.curtheres.2011.02.003.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  111. Patel S, Sturm A, Bobian M, Svider PF, Zuliani G, Kridel R. Opioid use by patients after Rhinoplasty. JAMA Facial Plast Surg. 2018;20(1):24–30. https://doi.org/10.1001/jamafacial.2017.1034.

    Article  PubMed  Google Scholar 

  112. Kazak Z, Mortimer N, Sekerci S. Single dose of preoperative analgesia with gabapentin (600 mg) is safe and effective in monitored anesthesia care for nasal surgery. Eur Arch Otorhinolaryngol. 2010;267(5):731–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA

    Aron Kandinov & Brandon K. Nguyen

  2. Department of Otolaryngology – Head and Neck Surgery, Loyola University Medical Center, Maywood, IL, USA

    Brian T. Yuhan

  3. Department of Otolaryngology – Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Andrew P. Johnson

  4. Bergen Medical Associates, Emerson, NJ, USA

    Peter F. Svider

  5. Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, NJ, USA

    Peter F. Svider

Authors
  1. Aron Kandinov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brandon K. Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brian T. Yuhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrew P. Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peter F. Svider
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aron Kandinov .

Editor information

Editors and Affiliations

  1. Bergen Medical Associates, Emerson, NJ, USA

    Peter F. Svider

  2. Anesthesiology, Pain Medicine, Columbia University Irving Medical Center, New York, NY, USA

    Anna A. Pashkova

  3. Otolaryngology – Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Andrew P. Johnson

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kandinov, A., Nguyen, B.K., Yuhan, B.T., Johnson, A.P., Svider, P.F. (2021). Evidence-Based Perioperative Analgesia for Otolaryngology: Head and Neck Surgery. In: Svider, P.F., Pashkova, A.A., Johnson, A.P. (eds) Perioperative Pain Control: Tools for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-030-56081-2_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-56081-2_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-56080-5

  • Online ISBN: 978-3-030-56081-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation