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Improving Pain Management in Maxillofacial Cosmetic Surgical Procedures

  • Marwan S. RizkEmail author
  • Samar S. Bahjah
  • Chakib M. Ayoub
Chapter

Abstract

Pain still ranks among the highest patient as well as surgeon concerns for unwanted surgical outcomes. Thus, pain management plays a major role in patient satisfaction and improving our patients’ safety. This chapter will review the pathogenesis of pain. Strategies for pain control will be addressed. Additionally, various pain disorders which can affect our patients’ postoperative course will be discussed.

References

  1. 1.
    Phillips DM. JCAHO pain management standards are unveiled. Joint Commission on Accreditation of Healthcare Organizations. JAMA. 2000;284:428–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Rawal N, Hylander J, Nydahl PA, Olofsson I, Gupta A. Survey of postoperative analgesia following ambulatory surgery. Acta Anaesthesiol Scand. 1997;41:1017–22.CrossRefPubMedGoogle Scholar
  3. 3.
    Apfelbaum JL, Chen C, Mehta SS, et al. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003;97:534–40.CrossRefPubMedGoogle Scholar
  4. 4.
    Rathmell JP, Wu CL, Sinatra RS, et al. Acute post-surgical pain management: a critical appraisal of current practice, December 2–4, 2005. Reg Anesth Pain Med. 2006;31(4 Suppl 1):1–42.PubMedGoogle Scholar
  5. 5.
    Seymour RA, Walton JG. Pain control after third molar surgery. Int J Oral Surg. 1984;13:457–85.CrossRefPubMedGoogle Scholar
  6. 6.
    Szmyd L, Shannon IL, Mohnac AM. Control of postoperative sequelae in impacted third molar surgery. J Oral Ther Pharmacol. 1965;1:491–6.PubMedGoogle Scholar
  7. 7.
    Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618–25.CrossRefPubMedGoogle Scholar
  8. 8.
    Woolf CJ, Ma Q. Nociceptors-noxious stimulus detectors. Neuron. 2007;55:353–64.CrossRefPubMedGoogle Scholar
  9. 9.
    Jahr CE, Jessell TM. ATP excites a subpopulation of rat dorsal horn neurones. Nature. 1983;304:730–3.CrossRefPubMedGoogle Scholar
  10. 10.
    Coffman J. The effect of aspirin in pain and hand blood flow responses to intra-arterial injection of bradykinin. Clin Pharmacol Ther. 1966;7:26–37.CrossRefPubMedGoogle Scholar
  11. 11.
    Douglas WW. Histamine and 5-hydroxytryptamine and their anatgonist. In: Gilman AG, Goodman LS, editors. The pharmacological basis of therapeutics. 7th ed. New York: Macmillan; 1985. p. 605–38.Google Scholar
  12. 12.
    Moncada S, Flower RJ, Vane JR. Prostaglandins, prostacyclin, thromboxane A2, and leukotrienes. In: Gilman AG, Goodman LS, editors. The pharmacological basis of therapeutics. 7th ed. New York: Macmillan; 1985. p. 660–73.Google Scholar
  13. 13.
    Higgs GA, Salmon JA, Henderson B. Pharmacokinetics of aspirin and salicylate in relation to inhibition of arachidonate cyclooxygenase and anti-inflammatory activity. Proc Natl Acad Sci U S A. 1987;84:1417–20.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Higgs GA. Arachidonic acid metabolism, pain and hyperalgesia: the mode of action of non-steroid mild analgesics. Br J Pharmacol. 1980;10(Suppl 2):233–5.CrossRefGoogle Scholar
  15. 15.
    Ferreira SH, Nakamura M, AbreuCatro MS. The hyperalgesic effects of prostacyclin and PGE2. Prostaglandins. 1978;16:31–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Woo YC, Park SS, Subieta AR, et al. Changes in tissue pH and temperature after incision indicate acidosis may contribute to postoperative pain. Anesthesiology. 2004;101:468–75.CrossRefPubMedGoogle Scholar
  17. 17.
    Kim TJ, Freml L, Park SS, et al. Lactate concentrations in incisions indicate ischemic-like conditions may contribute to postoperative pain. J Pain. 2007;8:59–66.CrossRefPubMedGoogle Scholar
  18. 18.
    Immke DC, McCleskey EW. Lactate enhances the acid-sensing Na channel on ischemia-sensing neurons. Nat Neurosci. 2001;4:869–70.CrossRefPubMedGoogle Scholar
  19. 19.
    D’Mello R, Dickenson AH. Spinal cord mechanisms of pain. Br J Anaesth. 2008;101:8–16.CrossRefPubMedGoogle Scholar
  20. 20.
    Campbell JN, Raja SN, Meyer RA. Myelinated afferents signal the hyperalgesia associated with nerve injury. Pain. 1988;32:89–94.CrossRefPubMedGoogle Scholar
  21. 21.
    McCartney CJL, Sinha A, Katz J. A qualitative systematic review of the role of N-Methyl-D-aspartate receptor antagonists in preventive analgesia. Anesth Analg. 2004;98:1385–400.CrossRefPubMedGoogle Scholar
  22. 22.
    Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9:807–19.CrossRefPubMedGoogle Scholar
  23. 23.
    Woolf CJ, Mannion RJ. Neuropathic pain: aetiology, symptoms, mechanisms, and management. Lancet. 1999;353:1959–64.CrossRefPubMedGoogle Scholar
  24. 24.
    Woolf CJ, Salter MW. Neuronal plasticity: increasing the gain in pain. Science. 2000;288:1765–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Sandkuhler J. Models and mechanisms of hyperalgesia and allodynia. Physiol Rev Suppl. 2009;89:707–58.CrossRefGoogle Scholar
  26. 26.
    Pogatzki-Zahn EM, Zahn PK. From preemptive to preventive analgesia. Curr Opin Anaesthesiol. 2006;19:551–5.CrossRefPubMedGoogle Scholar
  27. 27.
    White PF. The changing role of non-opioid analgesic techniques in the management of postoperative pain. Anesth Analg. 2005;101(5 Suppl):S5–22.CrossRefPubMedGoogle Scholar
  28. 28.
    Oderda GM, Evans RS, Lloyd J, et al. Cost of opioid-related adverse drug events in surgical patients. J Pain Symptom Manag. 2003;25:276–83.CrossRefGoogle Scholar
  29. 29.
    Gupta K, Kshirsagar S, Chang L, et al. Morphine stimulates angiogenesis by activating proangiogenic and survival promoting signaling and promotes breast tumor growth. Cancer Res. 2002;62:4491–8.PubMedGoogle Scholar
  30. 30.
    Singleton PA, Moss J. Effect of perioperative opioids on cancer recurrence: a hypothesis. Future Oncol. 2010;6:1237–42.CrossRefPubMedGoogle Scholar
  31. 31.
    Marret E, Kurdi O, Zufferey P, Bonnet F. Effects of nonsteroidal antiinflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials. Anesthesiology. 2005;102:1249–60.CrossRefPubMedGoogle Scholar
  32. 32.
    Elia N, Lysakowski C, Tramer MR. Does multimodal analgesia with acetaminophen, nonsteroidal antiinflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone? Meta-analyses of randomized trials. Anesthesiology. 2005;103:1296–304.CrossRefPubMedGoogle Scholar
  33. 33.
    Moiniche S, Romsing J, Dahl JB, Tramer MR. Nonsteroidal anti-inflammatory drugs and the risk of operative site bleeding after tonsillectomy: a quantitative systematic review. Anesth Analg. 2003;96:68–77, table of contents.CrossRefPubMedGoogle Scholar
  34. 34.
    Marret E, Flahault A, Samama CM, Bonnet F. Effects of postoperative, nonsteroidal, antiinflammatory drugs on bleeding risk after tonsillectomy: meta-analysis of randomized, controlled trials. Anesthesiology. 2003;98:1497–502.CrossRefPubMedGoogle Scholar
  35. 35.
    Romsing J, Moiniche S. A systematic review of COX-2 inhibitors compared with traditional NSAIDs, or different COX-2 inhibitors for post-operative pain. Acta Anaesthesiol Scand. 2004;48:525–46.CrossRefPubMedGoogle Scholar
  36. 36.
    White PF, Kehlet H, Liu S. Perioperative analgesia: what do we still know? Anesth Analg. 2009;108:1364–7.CrossRefPubMedGoogle Scholar
  37. 37.
    Nussmeier NA, Whelton AA, Brown MT, et al. Safety and efficacy of the cyclooxygenase-2 inhibitors parecoxib and valdecoxib after noncardiac surgery. Anesthesiology. 2006;104:518–26.CrossRefPubMedGoogle Scholar
  38. 38.
    Menigaux C, Guignard B, Fletcher D, Sessler DI, Dupont X, Chauvin M. Intraoperative small-dose ketamine enhances analgesia after outpatient knee arthroscopy. Anesth Analg. 2001;93:606–12.CrossRefPubMedGoogle Scholar
  39. 39.
    Subramaniam K, Subramaniam B, Steinbrook RA. Ketamine as adjuvant analgesic to opioids: a quantitative and qualitative systematic review. Anesth Analg. 2004;99:482–95, table of contents.CrossRefPubMedGoogle Scholar
  40. 40.
    Chandrakantan A, Glass PSA. Multimodal therapies for postoperative nausea and vomiting, and pain. Br J Anaesth. 2011;107(S1):i27–40.CrossRefPubMedGoogle Scholar
  41. 41.
    Hossmann V, Maling TJ, Hamilton CA, et al. Sedative and cardiovascular effects of clonidine and nitrazepam. Clin Pharmacol Ther. 1980;28:167–76.CrossRefPubMedGoogle Scholar
  42. 42.
    Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia. Br J Anaesth. 2009;102:117–22.CrossRefPubMedGoogle Scholar
  43. 43.
    Arain SR, Ruehlow RM, Uhrich TD, Ebert TJ. The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg. 2004;98:153–8, table of contents.CrossRefPubMedGoogle Scholar
  44. 44.
    Tufanogullari B, White PF, Peixoto MP, et al. Dexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables. Anesth Analg. 2008;106:1741–8.CrossRefPubMedGoogle Scholar
  45. 45.
    Michaloliakou C, Chung F, Sharma S. Preoperative multimodal analgesia facilitates recovery after ambulatory laparoscopic cholecystectomy. Anesth Analg. 1996;82:44–51.PubMedGoogle Scholar
  46. 46.
    Bisgaard T, Klarskov B, Kristiansen VB, et al. Multi-regional local anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study. Anesth Analg. 1999;89:1017–24.PubMedGoogle Scholar
  47. 47.
    Klein SM, Nielsen KC, Greengrass RA, Warner DS, Martin A, Steele SM. Ambulatory discharge after long-acting peripheral nerve blockade: 2382 blocks with ropivacaine. Anesth Analg. 2002;94:65–70, table of contents.PubMedGoogle Scholar
  48. 48.
    Vogel JD. Liposome bupivacaine (EXPAREL®) for extended pain relief in patients undergoing ileostomy reversal at a single institution with a fast-track discharge protocol: an IMPROVE Phase IV health economics trial. J Pain Res. 2013;6:605–10.PubMedPubMedCentralGoogle Scholar
  49. 49.
    US Food and Drug Administration. FDA Label Approved on 10/28/2011 (PDF) for EXPAREL. US Silver Spring, MD: US Food and Drug Administration. http://www.accessdata.fda.gov/drugsatfda_docs/nda/2011/022496Orig1s000TOC.cfm. Accessed 7 Mar 2014.
  50. 50.
    Chahar P, Cummings KC III. Liposomal bupivacaine: a review of a new bupivacaine formulation. J Pain Res. 2012;5:257–64.PubMedPubMedCentralGoogle Scholar
  51. 51.
    Chan MT, Wan AC, Gin T, Leslie K, Myles PS. Chronic postsurgical pain after nitrous oxide anesthesia. Pain. 2011;152:2514–20.CrossRefPubMedGoogle Scholar
  52. 52.
    Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain. Eur J Pain. 2003;7:181–8.CrossRefPubMedGoogle Scholar
  53. 53.
    Fountas KN, Kapsalaki EZ, Johnston KW, Smisson HF III, Vogel RL, Robinson JS Jr. Postoperative lumbar microdiscectomy pain. Minimalization by irrigation and cooling. Spine (Phila Pa 1976). 1999;24:1958–60.CrossRefGoogle Scholar
  54. 54.
    Politis C, Lambrichts I, Agbaje JO. Neuropathic pain after orthognathic surgery. Oral Maxillofac Surg. 2014;117(2):102–7.Google Scholar
  55. 55.
    Hillerup S. Iatrogenic injury to the inferior alveolar nerve: etiology, signs and symptoms, and observations on recovery. Int J Oral Maxillofac Surg. 2008;37(8):704–9.CrossRefPubMedGoogle Scholar
  56. 56.
    Renton T, Thexton A, Crean SJ, Hankins M. Simplifying the assessment of the recovery from surgical injury to the lingual nerve. Br Dent J. 2006;200(10):569–73.CrossRefPubMedGoogle Scholar
  57. 57.
    Lam NP, Donoff RB, Kaban LB, Dodson TB. Patient satisfaction after trigeminal nerve repair. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(5):538–43.CrossRefPubMedGoogle Scholar
  58. 58.
    Ziccardi VB, Zuniga JR. Nerve injuries after third molar removal. Oral Maxillofac Surg Clin North Am. 2007;19(1):105–15.CrossRefPubMedGoogle Scholar
  59. 59.
    Pogrel MA. The results of microneurosurgery of the inferior alveolar and lingual nerve. J Oral Maxillofac Surg. 2002;60(5):485–9.CrossRefPubMedGoogle Scholar
  60. 60.
    Susarla SM, Kaban LB, Donoff RB, et al. Functional sensory recovery after trigeminal nerve repair. J Oral Maxillofac Surg. 2007;65(1):60–5.Google Scholar
  61. 61.
    Wiffen PJ, McQuay HJ, Moore RA. Carbamazepine for acute and chronic pain. Cochrane Database Syst Rev. 2005;(3):CD005451.Google Scholar
  62. 62.
    Wiffen P, Collins S, McQuay H, et al. Anticonvulsant drugs for acute and chronic pain. Cochrane Database Syst Rev. 2005;(3):CD001133.Google Scholar
  63. 63.
    Sato J, Saitoh T, Notani K, et al. Diagnostic significance of carbamazepine and trigger zones in trigeminal neuralgia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(1):18–22.CrossRefPubMedGoogle Scholar
  64. 64.
    Taylor JC, Brauer S, Espir ML. Long-term treatment of trigeminal neuralgia with carbamazepine. Postgrad Med J. 1981;57(663):16–8.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Zakrzewska JM, Patsalos PN. Long-term cohort study comparing medical (oxcarbazepine) and surgical management of intractable trigeminal neuralgia. Pain. 2002;95(3):259–66.CrossRefPubMedGoogle Scholar
  66. 66.
    Fromm GH, Terrence CF, Chattha AS. Baclofen in the treatment of trigeminal neuralgia: double-blind study and long-term follow-up. Ann Neurol. 1984;15(3):240–4.CrossRefPubMedGoogle Scholar
  67. 67.
    Cheshire WP Jr. Defining the role for gabapentin in the treatment of trigeminal neuralgia: a retrospective study. J Pain. 2002;3(2):137–42.CrossRefPubMedGoogle Scholar
  68. 68.
    Beniczky S, Tajti J, Timea Varga E, et al. Evidence-based pharmacological treatment of neuropathic pain syndromes. J Neural Transm. 2005;112(6):735–49.CrossRefPubMedGoogle Scholar
  69. 69.
    Saarto T, Wiffen PJ. Antidepressants for treating neuropathic pain. Cochrane Evid. 2007:CD005454.Google Scholar
  70. 70.
    Collins S, Sigtermans MJ, Dahan A, Zuurmond WW, Perez RS. NMDA receptor antagonists for the treatment of neuropathic pain. Pain Med. 2010;11:1726–42.CrossRefPubMedGoogle Scholar
  71. 71.
    Bonelli S, Conoscente F, Movilia PG, Restelli L, Francucci B, Grossi E. Regional intravenous guanethidine vs. stellate ganglion block in reflex sympathetic dystrophies: a randomized trial. Pain. 1983;16:297–307.CrossRefPubMedGoogle Scholar
  72. 72.
    Peters G, Nurmikko TJ. Peripheral and gasserian ganglion-level procedures for the treatment of trigeminal neuralgia. Clin J Pain. 2002;18(1):28–34.CrossRefPubMedGoogle Scholar
  73. 73.
    Quinn JH, Weil T. Trigeminal neuralgia: treatment by repetitive peripheral neurectomy. Supplemental report. J Oral Surg. 1975;33(8):591–5.PubMedGoogle Scholar
  74. 74.
    Pradel W, Hlawitschka M, Eckelt U, et al. Cryosurgical treatment of genuine trigeminal neuralgia. Br J Oral Maxillofac Surg. 2002;40(3):244–7.CrossRefPubMedGoogle Scholar
  75. 75.
    Fardy MJ, Zakrzewska JM, Patton DW. Peripheral surgical techniques for the management of trigeminal neuralgia alcohol and glycerol injections. Acta Neurochir. 1994;129(3–4):181–4.CrossRefPubMedGoogle Scholar
  76. 76.
    Erdem E, Alkan A. Peripheral glycerol injections in the treatment of idiopathic trigeminal neuralgia: retrospective analysis of 157 cases. J Oral Maxillofac Surg. 2001;59(10):1176–80.CrossRefPubMedGoogle Scholar
  77. 77.
    Taha JM, Tew JM Jr. Comparison of surgical treatments for trigeminal neuralgia: reevaluation of radiofrequency rhizotomy. Neurosurgery. 1996;38(5):865–71.CrossRefPubMedGoogle Scholar
  78. 78.
    Hampf G, Vikkula J, Ylipaavalniemi P, Aalberg V. Psychiatric disorders in orofacial dysaesthesia. Int J Oral Maxillofac Surg. 1987;16:402–7.CrossRefPubMedGoogle Scholar
  79. 79.
    Vickers ER, Boocock H, Harris RD, et al. Analysis of the acute postoperative pain experience following oral surgery: identification of ‘unaffected’, ‘disabled’ and ‘depressed, anxious and disabled’ patient clusters. Aust Dent J. 2006;51:69–77.CrossRefPubMedGoogle Scholar
  80. 80.
    Varamini P, Goh WH, Mansfeld FM, et al. Peripherally acting novel lipoendomorphin-1 peptides in neuropathic pain without producing constipation. Bioorg Med Chem. 2013;21:1898–904.CrossRefPubMedGoogle Scholar
  81. 81.
    Carlsson-Jonsson A, Gao T, Hao JX, et al. N-terminal truncations of substance P 1-7 amide affect its action on spinal cord injury-induced mechanical allodynia in rats. Eur J Pharmacol. 2014;738:319–25.CrossRefPubMedGoogle Scholar
  82. 82.
    Serhan CN, Dalli J, Karamnov S, et al. Macrophage proresolving mediator maresin 1 stimulates tissue regeneration and controls pain. FASEB J. 2012;26:1755–65.CrossRefPubMedPubMedCentralGoogle Scholar
  83. 83.
    Ellis JA, Mejia Munne JC, Winfree CJ. Trigeminal branch stimulation for the treatment of intractable craniofacial pain. J Neurosurg. 2015;123:283–8.CrossRefPubMedGoogle Scholar
  84. 84.
    Vickers ER, Karsten E, Flood J, Lilischkis R. A preliminary report on stem cell therapy for neuropathic pain in humans. J Pain Res. 2014;7:255–63.CrossRefPubMedPubMedCentralGoogle Scholar
  85. 85.
    Katusic S, Williams DB, Beard CM, et al. Incidence and clinical features of glossopharyngeal neuralgia, Rochester, Minnesota, 1945–1984. Neuroepidemiology. 1991;10(5–6):266–75.CrossRefPubMedGoogle Scholar
  86. 86.
    Olesen J, Bousser M-G, Diener HC, et al. The international classification of headache disorders. 2nd edition. Cephalalgia. 2004;24(Suppl 1):24–150.Google Scholar
  87. 87.
    Renton T. Persistent pain after dental surgery. Rev Pain. 2011;5(1):8–17.CrossRefPubMedPubMedCentralGoogle Scholar
  88. 88.
    Evans RW, Agostoni E. Persistent idiopathic facial pain. Headache. 2006;46(8):1298–300.CrossRefPubMedGoogle Scholar
  89. 89.
    Pfaffenrath V, Rath M, Pollmann W, et al. Atypical facial pain–application of the IHS criteria in a clinical sample. Cephalalgia. 1993;13(Suppl 12):84–8.CrossRefPubMedGoogle Scholar
  90. 90.
    Baad-Hansen L. Atypical odontalgia—pathophysiology and clinical management. J Oral Rehabil. 2008;35(1):1–11.CrossRefPubMedGoogle Scholar
  91. 91.
    Birklein F. Complex regional pain syndrome. J Neurol. 2005;252(2):131–8.CrossRefPubMedGoogle Scholar
  92. 92.
    Wasner G, Schattschneider J, Baron R. Skin temperature side differences da diagnostic tool for CRPS? Pain. 2002;98(1–2):19–26.CrossRefPubMedGoogle Scholar
  93. 93.
    Benoliel R, Eliav E. Neuropathic orofacial pain. Oral Maxillofacial Surg Clin North Am. 2008;20:237–54.CrossRefGoogle Scholar
  94. 94.
    Melis M, Zawawi K, al-Badawi E, et al. Complex regional pain syndrome in the head and neck: a review of the literature. J Orofac Pain. 2002;16(2):93–104.PubMedGoogle Scholar

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© Springer International Publishing AG 2018

Authors and Affiliations

  • Marwan S. Rizk
    • 1
    Email author
  • Samar S. Bahjah
    • 1
  • Chakib M. Ayoub
    • 2
  1. 1.Department of AnesthesiologyAmerican University of Beirut Medical CenterBeirutLebanon
  2. 2.Duke University School of MedicineDurhamUSA

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